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视网膜前膜手术:解剖学和功能学结果

Epiretinal membrane surgery: anatomic and functional outcomes.

作者信息

García-Fernández M, Castro Navarro J, González Castaño C, García Alonso A, Fonollá Gil M

机构信息

Sección de Retina, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.

出版信息

Arch Soc Esp Oftalmol. 2013 Apr;88(4):139-44. doi: 10.1016/j.oftal.2012.07.002. Epub 2012 Sep 28.

Abstract

OBJECTIVE

To study the influence of anatomic preoperative characteristics (based on the parameter, foveal central thickness, measured by optical coherence tomography) and functional characteristics (based on the parameter, best corrected visual acuity, [BCVA]) on functional recovery after epiretinal membrane (ERM) surgery.

METHODS

A total of 88 eyes (of 86 patients), on whom a vitrectomy due to ERM was performed during a 3 years period were reviewed in this longitudinal, prospective study. An analysis was made of, ERM aetiology, BCVA, presence or absence of metamorphopsia, lens status, and central foveal thickness. Data relating to surgery and local complications, changes in BCVA, and changes in foveal central thickness were collected during the follow-up period.

RESULTS

An improvement was in observed in BCVA in 82%, as well as a decrease in foveal thickness in 79% of the eyes which underwent surgery, both of these being statistically significant (P<.01). However, most of the patients showed different grades of oedema and/or macular thickening in the postoperative period. A significant correlation was found between preoperative and postoperative BCVA (P=.001), and also between preoperative and postoperative central foveal thickness (P=.004), but not between BCVA and foveal thickness.

CONCLUSIONS

There is functional recovery in terms of BCVA in more than 80% of the patients after ERM surgery. Most of the eyes showed persistent macular thickening, but this did not seem to have influenced the final BCVA. The best determinant of postoperative functional recovery (postoperative visual acuity) is, in our experience, the preoperative BCVA, and not the macular thickness.

摘要

目的

研究解剖学术前特征(基于光学相干断层扫描测量的参数,即黄斑中心厚度)和功能特征(基于参数,最佳矫正视力[BCVA])对视网膜前膜(ERM)手术后功能恢复的影响。

方法

在这项纵向、前瞻性研究中,回顾了86例患者的88只眼睛,这些眼睛在3年期间因ERM接受了玻璃体切除术。分析了ERM病因、BCVA、是否存在视物变形、晶状体状态和中央黄斑厚度。在随访期间收集了与手术和局部并发症、BCVA变化以及黄斑中心厚度变化相关的数据。

结果

82%的接受手术的眼睛BCVA有所改善,79%的眼睛黄斑厚度有所降低,这两者均具有统计学意义(P<.01)。然而,大多数患者在术后出现了不同程度的水肿和/或黄斑增厚。术前和术后BCVA之间存在显著相关性(P=.001),术前和术后中央黄斑厚度之间也存在显著相关性(P=.004),但BCVA和黄斑厚度之间不存在相关性。

结论

ERM手术后超过80%的患者在BCVA方面有功能恢复。大多数眼睛显示黄斑持续增厚,但这似乎并未影响最终的BCVA。根据我们的经验,术后功能恢复(术后视力)的最佳决定因素是术前BCVA,而非黄斑厚度。

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