Vitreo-retina Department, Giridhar Eye Institute, Cochin, India.
Retina. 2019 Feb;39(2):314-318. doi: 10.1097/IAE.0000000000001939.
To evaluate the efficacy and optimum timing for resurgery in case of persistent macular hole (MH).
Twenty-five eyes of 25 patients who underwent fluid-air exchange with intravitreal C3F8 for persistent MH after vitrectomy + internal limiting membrane peeling + SF6 were included in the study. Best-corrected visual acuity, optical coherence tomography features including base diameter and configuration of MH, and time duration between the two surgeries were noted.
Patients who underwent resurgery within 3 months of the first surgery had better anatomical closure rate compared with those who underwent resurgery after 3 months (P < 0.05). Significant improvement was seen in best-corrected visual acuity in eyes with closed MH. Eyes having MH with irregular edges on optical coherence tomography had better anatomical closure rates compared with the eyes having MH with round edges.
Patients undergoing repeat gas injection within 3 months of the primary surgery for persistent MH have better anatomical closure rates compared with late intervention.
评估持续性黄斑裂孔(MH)再次手术的疗效和最佳时机。
对 25 例 25 眼接受玻璃体切除联合内界膜剥除联合 SF6 后行液-气交换联合眼内 C3F8 治疗持续性 MH 的患者进行研究。记录最佳矫正视力、光学相干断层扫描(OCT)特征,包括 MH 的基底部直径和形态,以及两次手术之间的时间间隔。
与 3 个月后再次手术的患者相比,首次手术后 3 个月内再次手术的患者具有更高的解剖闭合率(P<0.05)。MH 闭合眼的最佳矫正视力显著提高。OCT 上 MH 边缘不规则的眼比 MH 边缘规则的眼具有更高的解剖闭合率。
与晚期干预相比,初次手术后 3 个月内行重复气体注入的患者再次手术具有更好的解剖闭合率。