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[高度近视黄斑裂孔伴视网膜脱离的单层反转内界膜瓣技术观察]

[Observation of single-layered inverted internal limiting membrane flap technique for macular hole with retinal detachment in high myopia].

作者信息

Xu C Z, Wu J H, He J W, Feng C

机构信息

Aier School of Ophthalmology, Central South University, Changsha 410000, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2017 May 11;53(5):338-343. doi: 10.3760/cma.j.issn.0412-4081.2017.05.005.

Abstract

To compare the outcome of pars plana vitrectomy (PPV) with a single-layered inverted internal limiting membrane (ILM) flap versus PPV with ILM peeling for the treatment of macular hole associated retinal detachment (MHRD) in high myopia. In a retrospective cohort study, PPV with 2 kinds of adjuvant surgical procedures were used in 35 moderately high myopia eyes with MHRD. These eyes were divided into 2 groups: group 1 (17 eyes) receiving PPV and ILM peeling and group 2 (18 eyes) receiving PPV with a single-layered inverted ILM flap. Anatomical reattachment of the retina, macular hole closure, and best-corrected visual acuity (BCVA) were measured at 6 months after surgery. The retina was successfully reattached in all cases. The difference of the retinal reattachment rate between the two groups was not statistically significant (Fisher's exact test, 1.000). The rate of macular hole closure was 47.1% in group 1 (8 eyes) and 88.9% in group 2 (16 eyes). The difference of the macular hole closure rate between the two groups was statistically significant (Fisher's exact test, 0.012). Significant improvement in logarithm of minimal angle of resolution (logMAR) BCVA was achieved in both groups. There was no difference in the initial, final, or improved logMAR BCVA in the 2 groups. Single-layered inverted ILM flap technique effectively helps close the macular hole in moderately high myopia with MHRD. This may prevent the possible redetachment from the macular hole. -.

摘要

比较经平坦部玻璃体切除术(PPV)联合单层反转内界膜(ILM)瓣与PPV联合ILM剥除术治疗高度近视性黄斑裂孔性视网膜脱离(MHRD)的疗效。在一项回顾性队列研究中,35只患有MHRD的中度高度近视眼中采用了PPV联合2种辅助手术方法。这些眼睛被分为2组:第1组(17只眼)接受PPV联合ILM剥除术,第2组(18只眼)接受PPV联合单层反转ILM瓣术。在术后6个月测量视网膜的解剖复位、黄斑裂孔闭合情况以及最佳矫正视力(BCVA)。所有病例视网膜均成功复位。两组间视网膜复位率的差异无统计学意义(Fisher精确检验,P = 1.000)。第1组黄斑裂孔闭合率为47.1%(8只眼),第2组为88.9%(共16只眼)。两组间黄斑裂孔闭合率的差异有统计学意义(Fisher精确检验,P = 0.012)。两组的最小分辨角对数(logMAR)BCVA均有显著改善。两组在初始、最终或改善后的logMAR BCVA方面无差异。单层反转ILM瓣技术可有效帮助中度高度近视性MHRD患者闭合黄斑裂孔。这可能预防黄斑裂孔导致的视网膜再次脱离。

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