Chen Y Y, Lu N, Li J P, Yu J, Yu Y J, Shi X Y
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2018 Dec 25;98(48):3941-3945. doi: 10.3760/cma.j.issn.0376-2491.2018.48.007.
To evaluate the results of pars plana vitrectomy (PPV) with peeling of the inner limiting membrane (ILM) in patients with laser-induced macular hole. The clinical data of 11 patients (12 eyes) with decreased visual acuity due to laser-induced macular hole from January 2014 to December 2017 were retrospectively studied.All patients underwent routine examination, fundus photography and optical coherence tomography (OCT). Patients were observed every two weeks. PPV with ILM peeling was performed when macular hole was enlarged. Closure of macular hole, pre- and post-operation visual acuity were observed. A total of 11 male patients (12 eyes)aged (18±4) years were included in the study.Laser instruments which lead to macular hole consisted of laser toy (3 eye), laser pen (4 eye), laser torch (1 eye) and cosmetic laser instrument (4 eyes). All patients were followed up every two weeks and evaluated by OCT. None of the macular hole was spontaneously closed in this study. All Macular holes were enlarged in 1-3 months of follow-up and underwent PPV with ILM peeling immediately. All of the macular hole with PPV and ILM peeling were completely closed. During follow-up, the best-corrected visual acuity(BCVA) of 10 eyes (10/12) were found to increase above 3 lines and BCVA of 7 eyes(7/12) were found to be more than 0.5. Only 1 eye maintained the same visual acuity after the surgery which might be due to long course, large macular hole diameter (850 μm) and serious retinal pigment epithelium (RPE) damage. Early PPV with ILM peeling for laser induced macular hole might benefit for the closure rate of macular hole and better visual acuity prognosis.
评估玻璃体切割术（PPV）联合内界膜（ILM）剥除术治疗激光诱导性黄斑裂孔患者的效果。回顾性研究2014年1月至2017年12月期间因激光诱导性黄斑裂孔导致视力下降的11例患者（12只眼）的临床资料。所有患者均接受常规检查、眼底照相及光学相干断层扫描（OCT）。每两周观察患者一次。当黄斑裂孔扩大时，行PPV联合ILM剥除术。观察黄斑裂孔闭合情况及手术前后视力。本研究共纳入11例男性患者（12只眼），年龄（18±4）岁。导致黄斑裂孔的激光仪器包括激光玩具（3只眼）、激光笔（4只眼）、激光手电筒（1只眼）和美容激光仪器（4只眼）。所有患者每两周随访一次，并通过OCT进行评估。本研究中无一例黄斑裂孔自发闭合。所有黄斑裂孔在随访1 - 3个月时均扩大，并立即行PPV联合ILM剥除术。所有行PPV联合ILM剥除术的黄斑裂孔均完全闭合。随访期间，10只眼（10/12）的最佳矫正视力（BCVA）提高超过3行，7只眼（7/12）的BCVA大于0.5。仅1只眼术后视力维持不变，可能是由于病程长、黄斑裂孔直径大（850μm）及视网膜色素上皮（RPE）损伤严重。早期行PPV联合ILM剥除术治疗激光诱导性黄斑裂孔可能有利于提高黄斑裂孔闭合率及改善视力预后。
