Macula Unit, Barraquer Ophthalmology Clinic, Barcelona, Spain.
Retina. 2012 May;32(5):918-21. doi: 10.1097/IAE.0b013e318229b20e.
To report the results of vitrectomy with internal limiting membrane peeling and C3F8 tamponade for macular hole without postoperative face-down posturing in 208 eyes.
The study included 208 eyes on an uncontrolled retrospective review, undergoing pars plana vitrectomy with trypan blue-assisted internal limiting membrane peeling and C3F8 tamponade, without subsequent face-down posturing. All patients were followed-up at 1 day, 1 week, 3 months, and 12 months postoperatively. Biomicroscopy and optical coherence tomography were used to assess macular hole closure at 1 day, 1 week, 3 months, and 12 months postoperatively. Pre- and postoperative visual acuity by Snellen chart was compared.
In 208 eyes with idiopathic macular hole, preoperative mean visual acuity was 20/200 and final visual acuity was 20/40 (P = 0.00017). Anatomic macular hole closure rate was 81.3%.
In agreement with published studies, combined phacovitrectomy without face-down posturing after macular hole surgery seems effective and safe, showing anatomical improvement and favorable best-corrected visual acuity. Isolating the macula from vitreous fluid with a large long-lasting gas-fill may render postoperative posturing unnecessary. Eliminating face-down posturing may increase patient acceptance and compliance.
报告 208 例黄斑裂孔患者行玻璃体切除联合内界膜剥除和 C3F8 填充，术后不采取面朝下体位的结果。
本研究为回顾性非对照研究，208 例患者行标准三通道经睫状体平坦部玻璃体切除术，术中使用 0.02%台盼蓝辅助内界膜剥除和 C3F8 填充，术后不采取面朝下体位。所有患者均于术后第 1 天、第 1 周、第 3 个月和第 12 个月进行随访。术后第 1 天、第 1 周、第 3 个月和第 12 个月通过生物显微镜和光学相干断层扫描评估黄斑裂孔闭合情况。比较术前和术后的视力。
208 例特发性黄斑裂孔患者中，术前平均视力为 20/200，最终视力为 20/40（P=0.00017）。黄斑裂孔解剖闭合率为 81.3%。
与已发表的研究一致，黄斑裂孔手术后联合白内障玻璃体切除术且术后不采取面朝下体位似乎是有效且安全的，可改善解剖结构，提高最佳矫正视力。用大剂量、长时程的气体填充将黄斑与玻璃体隔开，可能使术后面朝下体位成为不必要。消除面朝下体位可能会提高患者的接受度和依从性。
