Department of Ophthalmology and Visual Sciences, Washington University, St. Louis School of Medicine, St. Louis, MO, USA.
Can J Ophthalmol. 2011 Apr;46(2):186-90. doi: 10.3129/i10-100.
To determine the correlation between clinically observed posterior vitreous detachment (PVD) and both surgical status of the hyaloid and the visual outcome following epiretinal membrane (ERM) surgery.
Retrospective chart review.
One hundred and nine eyes of 109 consecutive patients who underwent vitrectomy and repair of idiopathic ERM between January 2006 and September 2008.
Preoperative exam notes from selected charts were reviewed for the presence or absence of a PVD. Operative notes were queried to whether the hyaloid was attached or detached at the onset of surgery. The postoperative visual acuity (VA) was correlated with the intraoperative status of the hyaloid. Preoperative observation of PVD was correlated with the hyaloid status at the time of vitrectomy.
Hyaloid status did not impact postoperative VA. Eyes with an attached hyaloid at the onset of surgery had an average postoperative best corrected visual acuity (BCVA) of 20/60 and eyes with PVDs found during surgery had an average BCVA of 20/60(+1) (p < 0.66). Of the 109 patients, 72 had a preoperative fundoscopic examination whose results positively correlated with the intraoperative status of the hyaloid.
Having an attached hyaloid did not have a significant impact on postoperative visual outcomes in eyes undergoing ERM when compared with outcomes for eyes having a detached hyaloids prior to surgery. Detection of a PVD on preoperative fundoscopic examination was highly sensitive for a "true" PVD, i.e., actual detachment of the posterior hyaloidmembrane as confirmed during surgery.
确定临床观察到的后玻璃体脱离(PVD)与特发性视网膜内膜(ERM)手术后的前玻璃体状态和视觉结果之间的相关性。
回顾性图表审查。
2006 年 1 月至 2008 年 9 月期间接受玻璃体切除术和特发性 ERM 修复的 109 例连续患者的 109 只眼。
从选定的图表中查看术前检查记录,以确定是否存在 PVD。询问手术记录中前玻璃体是否在手术开始时附着或分离。将术后视力(VA)与前玻璃体的术中状态相关联。将术前观察到的 PVD 与玻璃体切除术时的前玻璃体状态相关联。
前玻璃体状态不影响术后 VA。手术开始时前玻璃体附着的眼睛术后最佳矫正视力(BCVA)平均为 20/60,术中发现 PVD 的眼睛术后 BCVA 平均为 20/60(+1)(p < 0.66)。在 109 例患者中,72 例进行了术前眼底检查,其结果与前玻璃体的术中状态呈正相关。
与术前前玻璃体分离的眼睛相比,ERM 手术后前玻璃体附着的眼睛的术后视觉结果没有显著影响。术前眼底镜检查发现 PVD 对“真正”PVD(即术中证实的后玻璃体膜实际分离)具有高度敏感性。