Ebihara Yoko, Okada Akira, Kakinoki Masashi, Ishii Masahiro, Ohji Masahito
From the Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan.
Retin Cases Brief Rep. 2008 Winter;2(1):67-9. doi: 10.1097/01.iae.0000247170.41710.ea.
The authors report a case of retinal detachment in an emmetropic eye secondary to development of a traumatic macular hole treated by removal of the internal limiting membrane (ILM) with a good visual outcome.
A 13-year-old boy was hit in his left eye by a football. The best-corrected visual acuity (BCVA) of the left eye was 20/40. A traumatic macular hole was present without posterior vitreous detachment. A retinal detachment secondary to a traumatic macular hole developed and BCVA decreased to 20/60 6 weeks after the injury Because the retinal detachment became more extensive 3 months after the injury, vitreous surgery was performed with creation of a posterior vitreous separation, followed by removal of the ILM surrounding the macular hole using 0.5% indocyanine green stain. Fluid-air exchange was performed followed by 20% SF6 gas tamponade.
The retina was reattached and the traumatic macular hole closed. The VA of the left eye improved to 20/30 1 month postoperatively. No serious complications occurred during follow-up.
Vitreous surgery with removal of the ILM appears to be a useful technique for treating traumatic macular holes with retinal detachments in emmetropic eyes and could achieve good visual outcomes in some cases.
作者报告一例正视眼因外伤性黄斑裂孔发展导致视网膜脱离的病例,通过去除内界膜(ILM)治疗,视觉效果良好。
一名13岁男孩左眼被足球击中。左眼最佳矫正视力(BCVA)为20/40。存在外伤性黄斑裂孔,无玻璃体后脱离。受伤6周后,外伤性黄斑裂孔继发视网膜脱离,BCVA降至20/60。由于受伤3个月后视网膜脱离范围扩大,遂行玻璃体手术,造成玻璃体后脱离,随后使用0.5%吲哚菁绿染色剂去除黄斑裂孔周围的ILM。进行液气交换,随后用20%的六氟化硫气体填塞。
视网膜复位,外伤性黄斑裂孔闭合。术后1个月,左眼视力提高到20/30。随访期间未发生严重并发症。
去除ILM的玻璃体手术似乎是治疗正视眼中伴有视网膜脱离的外伤性黄斑裂孔的一种有效技术,在某些情况下可取得良好的视觉效果。