小梁切除术后的继发性视网膜前膜

Secondary Epiretinal Membrane After Trabeculectomy.

作者信息

Vieira Luísa, Cabugueira Ana, Borges Bárbara, Carvalho Vanessa, Noronha Manuel, Abegão Pinto Luis, Reina Maria, Dutra Medeiros Marco

机构信息

*Department of Ophthalmology, Central Lisbon Hospital Center †Institute of Pharmacology and Neurosciences, Faculty of Medicine, University of Lisbon ‡NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal.

出版信息

J Glaucoma. 2016 Jun;25(6):e576-80. doi: 10.1097/IJG.0000000000000326.

DOI:10.1097/IJG.0000000000000326

PMID:26398580

Abstract

PURPOSE

To determine the frequency of epiretinal membranes (ERM) in eyes with primary open-angle glaucoma subjected to trabeculectomy.

METHODS

We conducted a retrospective study on patients subjected to trabeculectomy with at least a 6-month follow-up. Ophthalmologic examination and spectral-domain optical coherence tomography (SD-OCT) were analyzed. Eyes with previous surgical or laser treatments or other pathologies (other than glaucoma and ERM) were excluded.

RESULTS

A total of 50 eyes (40 patients) were included in this study. The mean follow-up time after surgery was 27.8 months. After surgery, 9 eyes (18%) had preretinal macular fibrosis and 19 eyes (38%) had cellophane macular reflex. Of the 16 eyes with a preoperative macular SD-OCT, 3 (18.8%) developed ERM and 4 (25%) progressed from cellophane macular reflex to preretinal macular fibrosis, after surgery. The ERM frequency did not differ significantly between eyes subjected to trabeculectomy with or without the use of antimetabolites (P=0.08), or between eyes subjected to simple or combined surgery (phacotrabeculectomy) (P=0.09).

CONCLUSION

Trabeculectomy may predispose one to the appearance and progression of ERM. Further studies are needed to clarify this intriguing relation.

摘要

目的

确定接受小梁切除术的原发性开角型青光眼患者视网膜前膜（ERM）的发生率。

方法

我们对接受小梁切除术且随访至少6个月的患者进行了一项回顾性研究。分析了眼科检查和光谱域光学相干断层扫描（SD-OCT）结果。排除既往有手术或激光治疗史或其他病变（青光眼和ERM除外）的眼睛。

结果

本研究共纳入50只眼（40例患者）。术后平均随访时间为27.8个月。术后，9只眼（18%）出现视网膜前黄斑纤维化，19只眼（38%）出现玻璃纸样黄斑反射。在术前进行黄斑SD-OCT检查的16只眼中，3只眼（18.8%）术后发生ERM，4只眼（25%）从玻璃纸样黄斑反射进展为视网膜前黄斑纤维化。小梁切除术使用或未使用抗代谢药物的眼之间ERM发生率无显著差异（P=0.08），单纯手术或联合手术（晶状体小梁切除术）的眼之间也无显著差异（P=0.09）。