Mao Xinbang, You Zhipeng, Cheng Yanhua
Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.
Exp Ther Med. 2019 Jul;18(1):589-595. doi: 10.3892/etm.2019.7610. Epub 2019 May 24.
The aim of the present study was to investigate whether internal limiting membrane (ILM) peeling in patients with myopic foveoschisis (MF) treated with 23-gauge (23G) vitrectomy improved the anatomical and visual outcomes. In this retrospective cohort study, from March 2014 to August 2017 at the Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University (Nanchang, China), 60 patients (60 eyes) with MF underwent 23G vitrectomy. The patients were grouped according to whether they underwent brilliant blue-assisted ILM peeling (peeling group) or not (non-peeling group). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) on optical coherence tomography were measured. There were 30 eyes in each group and the baseline characteristics were similar (all P>0.05). BCVA improved in 24 eyes (80%) in the peeling group and 25 eyes (83.3%) in the non-peeling group (P=0.922). Preoperative CMT was not significantly different between the peeling and non-peeling group (458±62.2 vs. 460±61.1 µm, respectively, P=0.229). However, postoperative CMT was significantly different between the peeling and non-peeling group (269.3±67.7 vs. 294.4±60.5 µm, respectively; P=0.015). In the peeling group, MF was completely resolved in all 30 eyes, but only in 26 eyes in the non-peeling group (P=0.038). Postoperative Amsler testing was positive in five eyes in the peeling group and 13 eyes in the non-peeling group (P=0.024). Complications were similar in both groups; postoperatively, there were one and two cases of iatrogenic peripheral retinal break, three and two cases of macular hole, and one and one case of retinal detachment in the peeling and non-peeling groups, respectively.23G vitrectomy combined with brilliant blue-assisted ILM peeling resulted in better visual and anatomical effects compared with 23G vitrectomy alone in patients with MF.
本研究的目的是调查在接受23G玻璃体切除术治疗的近视性黄斑劈裂（MF）患者中，内界膜（ILM）剥除是否能改善解剖学和视觉效果。在这项回顾性队列研究中，2014年3月至2017年8月期间，南昌大学第二附属医院眼科（中国南昌）的60例（60眼）MF患者接受了23G玻璃体切除术。根据患者是否接受亮蓝辅助ILM剥除术（剥除组）或未接受（非剥除组）进行分组。测量了光学相干断层扫描上的最佳矫正视力（BCVA）和中心黄斑厚度（CMT）。每组有30只眼，基线特征相似（所有P>0.05）。剥除组24只眼（80%）的BCVA得到改善，非剥除组25只眼（83.3%）的BCVA得到改善（P=0.922）。剥除组和非剥除组术前CMT无显著差异（分别为458±62.2和460±61.1 µm，P=0.229）。然而，剥除组和非剥除组术后CMT有显著差异（分别为269.3±67.7和294.4±60.5 µm；P=0.015）。在剥除组中，30只眼中的MF均完全消退，但在非剥除组中仅26只眼中的MF完全消退（P=0.038）。术后阿姆斯勒表检查剥除组5只眼阳性，非剥除组13只眼阳性（P=0.024）。两组并发症相似；术后，剥除组和非剥除组分别有1例和2例医源性周边视网膜裂孔、3例和2例黄斑裂孔以及1例和1例视网膜脱离。与单纯23G玻璃体切除术相比，23G玻璃体切除术联合亮蓝辅助ILM剥除术在MF患者中产生了更好的视觉和解剖学效果。
