Oleñik Andrea, Rios José, Mateo Carlos
*Instituto de Microcirugía Ocular (IMO), Barcelona, Spain; and †Department of Biostatistics, Hospital Clinic, University of Barcelona, Barcelona, Spain.
Retina. 2016 Sep;36(9):1688-93. doi: 10.1097/IAE.0000000000001010.
To evaluate the closure rate of macular holes in highly myopic eyes treated with the inverted internal limiting membrane flap technique.
Retrospective study in 33 consecutive patients (33 eyes) with a myopic macular hole (axial length ≥30 mm) and no associated macular retinoschisis, undergoing 23-gauge pars plana vitrectomy combined with the inverted internal limiting membrane flap technique.
Mean initial logarithm of the minimum angle of resolution best-corrected visual acuity was 0.59 (range, 0.22-1.8) (Snellen fraction, 20/80). At the 1-month postoperative control visit, the macular hole was closed in all patients. Reopening of the hole occurred in 2 patients. Visual acuity improved in 13 patients (39.4%): final mean ETDRS (Early Treatment Diabetic Retinopathy Study) improvement was +80 letters, and logarithm of the minimum angle of resolution was 0.4 (20/50). Staphyloma with macular involvement was present in all patients. Dissociated optic nerve fiber layer was observed in 25 patients (75.7%) and was absent in 2 (6.1%); in the remaining 6 patients, the layer could not be assessed. Gliosis was found in 14 patients (42.4%).
Vitrectomy plus the inverted internal limiting membrane flap technique was effective for treating macular holes in eyes with axial length ≥30 mm and no associated retinoschisis.
评估采用倒置内界膜瓣技术治疗高度近视眼黄斑裂孔的闭合率。
对33例连续患者（33只眼）进行回顾性研究，这些患者患有近视性黄斑裂孔（眼轴长度≥30mm）且无相关黄斑视网膜劈裂，接受了23G经平坦部玻璃体切除术联合倒置内界膜瓣技术。
初始最佳矫正视力最小分辨角的平均对数为0.59（范围0.22 - 1.8）（Snellen视力表分数，20/80）。术后1个月复查时，所有患者的黄斑裂孔均已闭合。2例患者出现裂孔重新开放。13例患者（39.4%）视力改善：最终平均早期糖尿病性视网膜病变研究（ETDRS）视力提高80个字母级，最小分辨角对数为0.4（20/50）。所有患者均存在伴有黄斑受累的葡萄肿。25例患者（75.7%）观察到视网膜神经纤维层分离，2例患者（6.1%）未观察到；其余6例患者无法评估该层情况。14例患者（42.4%）发现有视网膜胶质增生。
玻璃体切除术联合倒置内界膜瓣技术对于治疗眼轴长度≥30mm且无相关视网膜劈裂的黄斑裂孔有效。
