原发性玻璃体切除术联合不完全视网膜内界膜剥除成功修复后近视性黄斑劈裂的晚期复发
Late recurrence of myopic foveoschisis after successful repair with primary vitrectomy and incomplete membrane peeling.
作者信息
Sepúlveda Gonzalo, Chang Stanley, Freund K Bailey, Park SungPyo, Hoang Quan V
机构信息
*Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York; †Department of Ophthalmology, Fundacion Oftalmologica Los Andes, Santiago, Chile; ‡Vitreous, Retina, Macula Consultants of New York, New York, New York; and §Department of Ophthalmology, Hallym University Medical Center, Seoul, Korea.
出版信息
Retina. 2014 Sep;34(9):1841-7. doi: 10.1097/IAE.0000000000000156.
PURPOSE
To report three cases of late recurrence of myopic foveoschisis (MF) after initial successful repair with pars plana vitrectomy and membrane peeling to assess the importance of internal limiting membrane peeling.
METHODS
A retrospective noncomparative case series was performed of patients who underwent a primary pars plana vitrectomy by a single surgeon with successful resolution of MF, but eventually underwent repeat pars plana vitrectomy for recurrent MF. Best-corrected visual acuity, fundus photography, and optical coherence tomography were obtained at each examination.
RESULTS
Three eyes of three patients underwent pars plana vitrectomy for recurrent MF. Myopic foveoschisis recurrence occurred 6, 3.5, and 12 years after the primary vitrectomy, respectively. Repeat vitrectomy with staining and additional peeling of the internal limiting membrane resulted in good anatomical outcome and stabilization of visual acuity in all cases.
CONCLUSION
Late recurrence of MF after successful primary vitrectomy is described. Fibrocellular proliferation on residual cortical vitreous or incomplete internal limiting membrane peeling during the initial vitrectomy may underlie recurrence.
目的
报告三例近视性黄斑劈裂（MF）在初次经平坦部玻璃体切除术联合膜剥除成功修复后出现晚期复发的病例，以评估内界膜剥除的重要性。
方法
对由单一外科医生实施初次平坦部玻璃体切除术且MF成功消退，但最终因复发性MF而接受再次平坦部玻璃体切除术的患者进行一项回顾性非对照病例系列研究。每次检查时均获取最佳矫正视力、眼底照相和光学相干断层扫描结果。
结果
三名患者的三只眼因复发性MF接受了平坦部玻璃体切除术。近视性黄斑劈裂复发分别发生在初次玻璃体切除术后6年、3.5年和12年。再次玻璃体切除术联合内界膜染色及额外剥除在所有病例中均取得了良好的解剖学效果和视力稳定。
结论
描述了初次玻璃体切除术成功后MF的晚期复发情况。初次玻璃体切除术期间残留皮质玻璃体上的纤维细胞增殖或内界膜剥除不完全可能是复发的原因。
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