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黄斑扣带术治疗近视性黄斑劈裂:加拿大病例系列。

Macular buckle without vitrectomy for myopic macular schisis: a Canadian case series.

机构信息

Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta.

Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta.

出版信息

Can J Ophthalmol. 2019 Feb;54(1):60-64. doi: 10.1016/j.jcjo.2018.02.014. Epub 2018 May 3.

Abstract

OBJECTIVE

To determine the effectiveness of a macular buckle procedure without vitrectomy for the treatment of symptomatic myopic macular schisis.

DESIGN

Retrospective case series.

PARTICIPANTS AND METHODS

All patients who underwent surgery with placement of an NPB macular buckle (AJL Ophthalmic, Miñano, Álava, Spain) without vitrectomy for symptomatic myopic macular schisis were included. Visual acuity and anatomical outcomes based on optical coherence tomography (OCT) were reviewed.

RESULTS

Eight consecutive eyes from 7 patients were included. Six of the 7 patients were female and the mean age was 59 ± 6 years (range, 49-66 years). The mean follow-up duration was 11 ± 7 months (range, 3-23 months). Mean preoperative axial length was 29.54 ± 1.28 mm (range, 27.88-31.96 mm). Mean preoperative best-corrected visual acuity (BCVA) was 0.71 ± 0.29 logMAR (Snellen equivalent 20/103); mean postoperative BCVA was 0.46 ± 0.44 (Snellen equivalent 20/58; p = 0.19) and 87.5% of patients maintained or improved vision. Pre- and postoperative OCT images are included and discussed within. Preoperative ellipsoid zone status and postoperative central macular buckle indentation appear to be important in visual outcomes. Two patients required a buckle repositioning for persistent schisis. One patient developed a macular hole postoperatively that resolved with subsequent vitrectomy. There were no other complications.

CONCLUSIONS

The macular buckle is an effective and promising therapeutic option for myopic macular schisis.

摘要

目的

评估无玻璃体切割的黄斑扣带术治疗症状性近视性黄斑劈裂的疗效。

设计

回顾性病例系列。

参与者和方法

纳入所有接受 AJL 眼科公司(西班牙米尼亚诺)生产的非接触式后巩膜加固环(NPB)黄斑扣带术治疗症状性近视性黄斑劈裂且未行玻璃体切割的患者。回顾分析基于光学相干断层扫描(OCT)的视力和解剖学结果。

结果

共纳入 7 名患者的 8 只眼。7 名患者中有 6 名女性,平均年龄 59 ± 6 岁(范围,49-66 岁)。平均随访时间为 11 ± 7 个月(范围,3-23 个月)。平均术前眼轴长度为 29.54 ± 1.28mm(范围,27.88-31.96mm)。平均术前最佳矫正视力(BCVA)为 0.71 ± 0.29 logMAR(Snellen 等效值 20/103);平均术后 BCVA 为 0.46 ± 0.44(Snellen 等效值 20/58;p=0.19),87.5%的患者视力保持或提高。包括术前和术后的 OCT 图像,并进行了讨论。术前椭圆体带的状态和术后黄斑中央扣带压痕似乎对视功能结果很重要。2 例患者因劈裂持续存在需要重新定位扣带。1 例患者术后出现黄斑裂孔,随后行玻璃体切除术得以解决。无其他并发症。

结论

黄斑扣带术是治疗近视性黄斑劈裂的一种有效且有前途的治疗选择。

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