Muto Tetsuya, Nishimura Tomoharu, Yamaguchi Takefumi, Chikuda Makoto, Machida Shigeki
Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.
Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan.
Clin Ophthalmol. 2017 Aug 21;11:1527-1532. doi: 10.2147/OPTH.S141771. eCollection 2017.
Cataract progression after lens-sparing vitrectomy might differ according to original posterior segment diseases. Our objective was to analyze the refractive values after lens-sparing vitrectomy for macular hole (MH) and epiretinal membrane (ERM).
We reviewed the medical records of 25 MH patients (25 eyes) and 23 ERM patients (23 eyes) who underwent lens-sparing vitrectomy. Refractive changes in both groups were compared. All patients underwent 20-gauge three-port pars plana vitrectomy. Fluid-air exchange was performed during vitrectomy only in the MH group. The results were analyzed using the unpaired -test, chi-square test, or Fisher exact probability test, and multivariate analysis.
There were no significant differences in the patient's age (=0.45). The myopia progression rate (D/month) was higher in the MH group after surgery than that in the ERM group (=0.035). MH group had more females (=0.043), longer surgical time (<0.001), and higher frequencies of surgical adjuvants use (triamcinolone acetonide, =0.019; brilliant blue G, <0.001). The myopia progression rate in the MH group (=0.568, <0.001) correlated with female gender. However, no correlation was observed between longer surgical time and the use of surgical adjuvants.
The rate of myopia progression was higher in the MH group. Fluid-air exchange and gender may affect the rate of myopia progression.
保留晶状体玻璃体切除术后白内障进展情况可能因原发病变的后段疾病而异。我们的目的是分析黄斑裂孔（MH）和视网膜前膜（ERM）保留晶状体玻璃体切除术后的屈光值。
我们回顾了25例接受保留晶状体玻璃体切除术的MH患者（25只眼）和23例ERM患者（23只眼）的病历。比较两组的屈光变化。所有患者均接受20G三通道平坦部玻璃体切除术。仅在MH组玻璃体切除术中进行液气交换。结果采用非配对t检验、卡方检验或Fisher精确概率检验以及多因素分析。
患者年龄无显著差异（P = 0.45）。术后MH组近视进展率（D/月）高于ERM组（P = 0.035）。MH组女性更多（P = 0.043），手术时间更长（P < 0.001），手术辅助剂使用频率更高（曲安奈德，P = 0.019；亮蓝G，P < 0.001）。MH组近视进展率（P = 0.568，P < 0.001）与女性性别相关。然而，手术时间延长与手术辅助剂的使用之间未观察到相关性。
MH组近视进展率更高。液气交换和性别可能影响近视进展率。
