Mii Mei, Matsuoka Masato, Matsuyama Kayako, Otsu Yayoi, Nishimura Tetsuya
Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka, Japan.
Clin Ophthalmol. 2014 Sep 12;8:1837-44. doi: 10.2147/OPTH.S67619. eCollection 2014.
To report the surgical outcomes of 25-gauge vitrectomy in eyes with myopic foveoschisis (MF).
The medical records of 40 eyes of 36 patients that had undergone 25-gauge vitrectomy with internal limiting membrane peeling for MF were studied. The main outcome measures were the best-corrected visual acuity (BCVA) and the optical coherence tomography (OCT) findings. The eyes were divided into two groups: 1) those with a foveal detachment (FD; FD group); and 2) those without a FD (no-FD group).
The postoperative OCT images showed a resolution of the MF with a significant reduction in the central foveal thickness from the preoperative values in both the FD group (479±150 μm to 196±56 μm; P=0.002, mean ± standard deviation) and in the no-FD group (369±116 μm to 245±50 μm; P=0.001). The final mean BCVA significantly improved from the preoperative values in the FD group (0.96±0.53 logarithm of the minimum angle of resolution [logMAR] units to 0.70±0.56 logMAR units; P=0.009) and in the no-FD group (0.46±0.38 logMAR units to 0.34±0.36 logMAR units; P=0.007). The final BCVA in the FD group improved in 63%, remained unchanged in 31%, and worsened in 6%. In the no-FD group, the final BCVA improved in 21%, remained unchanged in 71%, and worsened in 8% of the eyes. A better final BCVA was significantly correlated with a better preoperative BCVA in both groups (P<0.001).
Twenty five-gauge vitrectomy results in favorable visual and anatomic outcomes for MF. We recommend that 25-gauge vitrectomy be used to treat eyes with MF.
报告25G玻璃体切除术治疗高度近视性黄斑劈裂(MF)的手术效果。
研究36例患者40只眼行25G玻璃体切除术联合内界膜剥除治疗MF的病历资料。主要观察指标为最佳矫正视力(BCVA)和光学相干断层扫描(OCT)结果。将患眼分为两组:1)黄斑脱离(FD)组;2)无黄斑脱离(无FD)组。
术后OCT图像显示MF得到缓解,FD组(479±150μm降至196±56μm;P=0.002,均值±标准差)和无FD组(369±116μm降至245±50μm;P=0.001)的中心黄斑厚度均较术前显著降低。FD组最终平均BCVA较术前显著提高(最小分辨角对数[logMAR]单位从0.96±0.53提高至0.70±0.56;P=0.009),无FD组也显著提高(从0.46±0.38 logMAR单位提高至0.34±0.36 logMAR单位;P=0.007)。FD组最终BCVA提高的占63%,不变的占31%,恶化的占6%。无FD组中,21%的患眼最终BCVA提高,71%不变,8%恶化。两组中,最终BCVA较好均与术前BCVA较好显著相关(P<0.001)。
25G玻璃体切除术治疗MF可获得良好的视力和解剖学效果。我们建议采用25G玻璃体切除术治疗MF患眼。