Huang Yao, Huang Weilin, Ng Danny S C, Duan Anli
*Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China; and †Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
Retina. 2017 Jun;37(6):1049-1054. doi: 10.1097/IAE.0000000000001322.
To identify the risk factors for the development of macular hole retinal detachment (MHRD) after vitrectomy without internal limiting membrane peeling for pathologic MF.
We retrospectively reviewed the records of 131 eyes (115 patients) treated with vitrectomy for pathologic MF from 2009 to 2014. The best-corrected visual acuity (BCVA), refractive error, axial length, and spectral-domain optical coherence tomography findings were analyzed.
Postoperative MHRD developed in 7 eyes (5.3%). Between patients with or without secondary MHRD after vitrectomy, there were no significant differences in age, sex, axial length, preoperative BCVA, refractive error, lens status, and presence of posterior staphyloma. Spectral-domain optical coherence tomography showed all 7 eyes (100%) had foveal detachment, while only 47 patients (37.9%) of 124 eyes had foveal detachment (P = 0.004). There was no significant difference between preoperative and postoperative BCVA in the 7 eyes with MHRD. The postoperative BCVA in the 124 eyes without MHRD was significantly improved (P < 0.001). Among the 124 eyes, both preoperative and postoperative BCVA of eyes with foveal detachment was worse than the eyes without foveal detachment (P < 0.001, respectively).
Preoperative foveal detachment is a risk factor for the development of MHRD after vitrectomy for pathologic MF.
确定在玻璃体切割术治疗病理性黄斑裂孔(MF)时不进行内界膜剥除术后发生黄斑裂孔性视网膜脱离(MHRD)的危险因素。
我们回顾性分析了2009年至2014年期间131只眼(115例患者)接受玻璃体切割术治疗病理性MF的病历。分析了最佳矫正视力(BCVA)、屈光不正、眼轴长度和频域光学相干断层扫描结果。
7只眼(5.3%)发生了术后MHRD。在玻璃体切割术后发生或未发生继发性MHRD的患者之间,年龄、性别、眼轴长度、术前BCVA、屈光不正、晶状体状态和后巩膜葡萄肿的存在情况均无显著差异。频域光学相干断层扫描显示,所有7只眼(100%)均有黄斑中心凹脱离,而124只眼中只有47例患者(37.9%)有黄斑中心凹脱离(P = 0.004)。7只发生MHRD的眼中术前和术后BCVA无显著差异。124只未发生MHRD的眼中术后BCVA显著改善(P < 0.001)。在124只眼中,有黄斑中心凹脱离的眼术前和术后BCVA均比无黄斑中心凹脱离的眼差(分别为P < 0.001)。
术前黄斑中心凹脱离是病理性MF玻璃体切割术后发生MHRD的危险因素。