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特发性黄斑裂孔术后黄斑兜带治疗近视性后葡萄肿相关性黄斑劈裂

Macular buckling for eyes with myopic foveoschisis secondary to posterior staphyloma.

机构信息

Instituto de Microcirugía Ocular, Barcelona, Spain.

出版信息

Retina. 2012 Jun;32(6):1121-8. doi: 10.1097/IAE.0b013e31822e5c32.

Abstract

PURPOSE

To determine the effectiveness of macular buckling in eyes with myopic foveoschisis and describe two methods of macular buckling: hard silicone implant and Ando plombe.

METHODS

Sixteen eyes of 16 consecutive patients with myopic foveoschisis who underwent surgery with the macular buckling procedure were studied. Pars plana vitrectomy combined with macular buckling with hard silicone implant was used in 6 eyes, whereas the other 10 eyes underwent pars plana vitrectomy and macular buckling with the Ando macular plombe.

RESULTS

Macular buckling, with both hard silicone implant and macular plombe resulted in reduction of retinal thickness in all patients. Best-corrected visual acuity improved in 14 of 16 eyes (87.5%), whereas it remained stable or decreased in 2 eyes (12.5%). Mean preoperative best-corrected visual acuity was 20/125 (mean logarithm of the minimal angle of resolution 0.8), whereas mean postoperative best-corrected visual acuity improved to 20/50 (mean logarithm of the minimal angle of resolution 0.39). Both methods showed a similar rate of complications, the most frequent being the development of localized areas of retinal pigment epithelium atrophy.

CONCLUSION

Combined pars plana vitrectomy and macular buckling is an effective approach to treat myopic foveoschisis with both anatomical and visual improvement. Despite a similar complication rate with both buckling techniques, macular buckling with the Ando plombe was found to be technically easier with shorter surgical times.

摘要

目的

确定黄斑扣带术治疗近视性黄斑劈裂的效果,并描述两种黄斑扣带术方法:硬性硅胶植入和安多 plombe。

方法

研究了 16 例连续患者的 16 只眼,这些患者均因近视性黄斑劈裂接受了黄斑扣带手术。6 只眼采用玻璃体切除术联合硬性硅胶植入黄斑扣带术,另 10 眼采用玻璃体切除术联合安多黄斑 plombe 黄斑扣带术。

结果

硬性硅胶植入和黄斑 plombe 黄斑扣带均使所有患者的视网膜厚度减少。16 只眼中的 14 只(87.5%)最佳矫正视力提高,而 2 只(12.5%)稳定或下降。术前最佳矫正视力平均为 20/125(最小角分辨率对数均值为 0.8),术后最佳矫正视力提高至 20/50(最小角分辨率对数均值为 0.39)。两种方法的并发症发生率相似,最常见的是局部视网膜色素上皮萎缩。

结论

联合玻璃体切除术和黄斑扣带术是治疗近视性黄斑劈裂的有效方法,可改善解剖和视力。尽管两种扣带技术的并发症发生率相似,但安多 plombe 黄斑扣带术在技术上更简单,手术时间更短。

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