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特发性黄斑视网膜前膜手术及内界膜剥除术:解剖学和功能转归

Idiopathic macular epiretinal membrane surgery and ILM peeling: anatomical and functional outcomes.

作者信息

Pournaras Constantin J, Emarah Ahmed, Petropoulos Ioannis K

出版信息

Semin Ophthalmol. 2011 Mar;26(2):42-6. doi: 10.3109/08820538.2010.544237.

Abstract

PURPOSE

Evaluation of the visual and anatomical outcomes following idiopathic macular epiretinal membrane (ERM) removal, with or without internal limiting membrane (ILM) peeling, and review of the literature.

METHODS

A retrospective study of 39 eyes operated for idiopathic ERM was conducted. Pars plana vitrectomy was combined with ERM removal and Indocyanine green (ICG) assisted ILM peeling in 24 eyes.

RESULTS

In Group A (without ILM peeling), mean preoperative BCVA was 0.48 logMAR (0.3 in decimal units), whereas mean postoperative BCVA was 0.37 logMAR (0.4 in decimal units). In Group B (with ILM peeling), mean preoperative BCVA was 0.58 logMAR (0.25 in decimal units), whereas mean postoperative BCVA was 0.31 logMAR (0.5 in decimal units). No statistically significant difference was observed between Groups A and B regarding preoperative or postoperative BCVA (p>0.1, Student's t-test). OCT measurement of postoperative foveal thickness reveled a significant decrease in thickness in both groups; however, no correlation was observed between postoperative BCVA and postoperative foveal thickness (Pearson's correlation coefficient = 0.139; p>0.1).

CONCLUSIONS

In spite of final visual acuity improvement following idiopathic ERM removal, recovery of a normal foveal thickness is not achieved in the majority of the cases. ICG assisted ILM peeling does not affect the functional outcome of idiopathic ERM removal.

摘要

目的

评估特发性黄斑视网膜前膜(ERM)切除术后的视力和解剖学结果,无论是否进行内界膜(ILM)剥除,并对相关文献进行综述。

方法

对39例行特发性ERM手术的患眼进行回顾性研究。24只眼行玻璃体切割术联合ERM切除及吲哚菁绿(ICG)辅助的ILM剥除术。

结果

A组(未行ILM剥除)术前平均最佳矫正视力(BCVA)为0.48 logMAR(小数视力为0.3),术后平均BCVA为0.37 logMAR(小数视力为0.4)。B组(行ILM剥除)术前平均BCVA为0.58 logMAR(小数视力为0.25),术后平均BCVA为0.31 logMAR(小数视力为0.5)。A组和B组术前或术后BCVA差异无统计学意义(p>0.1,Student t检验)。术后黄斑中心凹厚度的光学相干断层扫描(OCT)测量显示两组厚度均显著降低;然而,术后BCVA与术后黄斑中心凹厚度之间无相关性(Pearson相关系数=0.139;p>0.1)。

结论

尽管特发性ERM切除术后最终视力有所改善,但大多数病例未实现黄斑中心凹正常厚度的恢复。ICG辅助的ILM剥除不影响特发性ERM切除的功能结果。

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