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玻璃体内切除术联合或不联合内界膜撕除治疗各期近视牵引性黄斑病变。

Vitrectomy with or without internal limiting membrane peeling for each stage of myopic traction maculopathy.

机构信息

*Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan; and †Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

Retina. 2013 Nov-Dec;33(10):2018-25. doi: 10.1097/IAE.0b013e3182a4892b.

Abstract

PURPOSE

To evaluate the effect of vitrectomy on the best-corrected visual acuity (BCVA) and postoperative complications in highly myopic eyes with myopic traction maculopathy.

METHODS

The medical records of 71 eyes of 64 patients with myopic traction maculopathy and high myopia (≤-8.0 diopters and axial length, ≥26.0 mm) were reviewed. Twenty-six eyes had only macular retinoschisis, 30 eyes had foveal detachment, and 15 eyes had macular hole. The BCVA and complications were studied in eyes that underwent vitrectomy with or without internal limiting membrane (ILM) peeling.

RESULTS

The postoperative BCVA at the final visit significantly improved in the macular retinoschisis and the foveal detachment groups (P = 0.003 and P = 0.010, respectively) but not in the macular hole group (P = 0.069). The BCVA in the macular retinoschisis group and the foveal detachment group with ILM peeling significantly improved at the final visit (P = 0.003 and P = 0.010, respectively). The BCVA at the final visit significantly correlated with age (P = 0.026) and ILM peeling (P = 0.034). A recurrence of tractional macular detachment developed more frequently in eyes without ILM peeling (P = 0.018).

CONCLUSION

These results indicate that vitrectomy with ILM peeling can lead to improvement in vision in patients with macular retinoschisis or foveal detachment with visual impairments.

摘要

目的

评估玻璃体切割术对高度近视伴牵引性黄斑病变的最佳矫正视力(BCVA)和术后并发症的影响。

方法

回顾了 64 例高度近视(≤-8.0 屈光度和眼轴长度≥26.0mm)伴牵引性黄斑病变患者的 71 只眼的病历。26 只眼仅有黄斑视网膜劈裂,30 只眼有黄斑裂孔,15 只眼有黄斑裂孔。研究了行玻璃体切割术联合或不联合内界膜(ILM)剥除术的眼的 BCVA 和并发症。

结果

黄斑视网膜劈裂组和黄斑裂孔组的最终随访时的 BCVA 显著提高(P=0.003 和 P=0.010),但黄斑裂孔组无显著提高(P=0.069)。黄斑视网膜劈裂组和黄斑裂孔组行 ILM 剥除术后最终随访时的 BCVA 显著提高(P=0.003 和 P=0.010)。最终随访时的 BCVA 与年龄(P=0.026)和 ILM 剥除(P=0.034)显著相关。未行 ILM 剥除的眼牵引性黄斑脱离复发的频率更高(P=0.018)。

结论

这些结果表明,玻璃体切割术联合 ILM 剥除术可改善视力障碍的黄斑视网膜劈裂或黄斑裂孔患者的视力。

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