Department of Surgery, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts.
Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts; and.
Retin Cases Brief Rep. 2020 Spring;14(2):104-109. doi: 10.1097/ICB.0000000000000919.
To determine whether small macular hole closure can be achieved with 25-G vitrectomy surgery with internal limiting membrane peeling without the use of intraocular gas tamponade or facedown positioning.
25-G vitrectomy surgery with internal limiting membrane peeling without the use of intraocular gas tamponade or positioning was performed on 20 eyes with a small (<400-µm diameter), full-thickness macular hole.
In 17 of 20 eyes (85%), the hole had closed. Three holes had closed by Postoperative Day 1, 13 holes by Postoperative Week 1, 16 holes by Postoperative Week 2, and 17 holes by Postoperative Week 6. At Postoperative Month 1, vision improved in 16 of 17 eyes in which the macular hole had closed. One hole that had not closed at the first postoperative week and two holes that had not closed at the third postoperative week required follow-up surgery with intraocular gas tamponade and facedown positioning, after which the hole closed. The mean preoperative visual acuity was 0.626 logMAR (20/85), and the mean postoperative visual acuity after 1 month was 0.392 logMAR (20/50) (P < 0.001).
Vitrectomy surgery with internal limiting membrane peeling without the use of gas tamponade or positioning can achieve closure of small macular holes.
确定在不使用眼内气体填充或面朝下体位的情况下，通过 25-G 玻璃体切除术联合内界膜剥除术是否可以闭合小的（<400-µm 直径）全层黄斑裂孔。
对 20 只小（<400-µm 直径）全层黄斑裂孔眼行 25-G 玻璃体切除术联合内界膜剥除术，不使用眼内气体填充或体位。
20 只眼中有 17 只（85%）孔闭合。术后第 1 天有 3 个孔闭合，术后第 1 周有 13 个孔闭合，术后第 2 周有 16 个孔闭合，术后第 6 周有 17 个孔闭合。术后 1 个月，17 只黄斑裂孔闭合的眼中有 16 只视力改善。第 1 周术后未闭合的 1 个孔和第 3 周术后未闭合的 2 个孔需要进行眼内气体填充和面朝下体位的后续手术，此后孔闭合。术前平均视力为 0.626 logMAR（20/85），术后 1 个月平均视力为 0.392 logMAR（20/50）（P<0.001）。
不使用气体填充或体位的玻璃体切除术联合内界膜剥除术可以闭合小的黄斑裂孔。
