内界膜撕除时代孔源性视网膜脱离合并黄斑裂孔的处理
Management of rhegmatogenous retinal detachment with coexistent macular hole in the era of internal limiting membrane peeling.
机构信息
University of Minnesota Department of Ophthalmology, Minneapolis, Minnesota, USA.
出版信息
Am J Ophthalmol. 2011 Nov;152(5):815-9.e1. doi: 10.1016/j.ajo.2011.04.026. Epub 2011 Aug 16.
PURPOSE
To review outcomes of vitrectomy plus or minus scleral buckling for retinal detachment (RD) attributable to peripheral break(s) with noncausal macular hole, plus or minus internal limiting membrane (ILM) peeling.
DESIGN
Retrospective chart review.
METHODS
Forty-nine consecutive patients from March 1, 1998 to March 31, 2009 with RD attributable to peripheral break and macular hole were treated by vitrectomy. Five had no scleral buckle placed. Forty-three underwent ILM peeling.
RESULTS
The main outcome measures were retinal reattachment, macular hole status, and vision. Final retinal reattachment rate was 95.9% (47/49) with 1 and 100% with 2 operations. Final macular hole closure rate was 39/43 with ILM peeling (90.7%), and 2/6 without (33.3%, P value = .0041). Mean final acuity was 20/120, and 20/100 if the macular hole was closed.
CONCLUSION
Vitrectomy, plus or minus scleral buckle, with ILM peeling is effective for repair of RD with macular hole. ILM peeling can increase the rate of macular hole closure.
目的
回顾分析玻璃体切除术联合或不联合巩膜扣带术治疗周边裂孔性视网膜脱离（RD）伴非因果性黄斑孔，联合或不联合内界膜（ILM）剥除术的疗效。
设计
回顾性图表分析。
方法
1998 年 3 月 1 日至 2009 年 3 月 31 日期间，对 49 例由周边裂孔和黄斑孔引起的 RD 患者进行玻璃体切除术治疗。其中 5 例未行巩膜扣带术，43 例行 ILM 剥除术。
结果
主要观察指标为视网膜复位、黄斑孔状态和视力。初次手术和二次手术后的最终视网膜复位率分别为 95.9%（47/49）和 100%。行 ILM 剥除术的 43 例中，最终黄斑孔闭合率为 39/43（90.7%），而未行 ILM 剥除术的 6 例中，仅有 2/6 例（33.3%）黄斑孔闭合（P 值=0.0041）。最终平均视力为 20/120，如果黄斑孔闭合，则视力为 20/100。
结论
玻璃体切除术联合或不联合巩膜扣带术，联合或不联合 ILM 剥除术治疗黄斑孔性 RD 有效。ILM 剥除术可提高黄斑孔闭合率。
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