State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA.
Acta Ophthalmol. 2020 Jun;98(4):e470-e478. doi: 10.1111/aos.14305. Epub 2019 Nov 19.
To assess the functional and structural outcomes of macular buckling using a silicone sponge-titanium exoplant for the treatment of foveoschisis (FS) and full-thickness macular holes (FTMHs) in highly myopic eyes.
Forty-nine consecutive patients with high myopia who underwent macular buckling for the treatment of FS and FTMHs were included. The outcomes measured included the anatomical success rate with FS resolution, retinal reattachment, MH closure, best corrected visual acuity (BCVA), axial length (AL) and complications of surgery. Moreover, the correlations between the BCVA at year three and series of factors, including age, duration of symptoms, baseline BCVA, AL, surgical type, preoperative macular status and severity of myopic maculopathy, were analysed.
This study involved 28 patients (28 eyes) with FS and 21 patients (21 eyes) with FTMHs with macular detachment. Retinal reattachment was achieved in 100% of cases, while MH closure was achieved in 76.19% of cases. The BCVA significantly improved one year after macular buckling in the FS cases and two years after macular buckling in the FTMH cases, and it remained stable throughout the rest of the follow-up period. The mean AL decreased by 2.09 mm postoperatively. No major perioperative complications were observed, although one patient needed to explant the buckling device due to intolerable diplopia.
Macular buckling with a silicone sponge-titanium exoplant may represent a safe and effective surgical option for the treatment of FS and FTMH in highly myopic eyes. Macular buckling showed a high closure rate and virtually no tendency to recur.
评估使用硅胶海绵-钛外植体治疗高度近视患者中黄斑裂孔伴视网膜下液（FS）和全层黄斑孔（FTMH）的功能和结构结果。
纳入 49 例高度近视患者，接受黄斑裂孔外加压术治疗 FS 和 FTMH。观察指标包括 FS 消退、视网膜复位、MH 闭合、最佳矫正视力（BCVA）、眼轴长度（AL）以及手术并发症。此外，还分析了术后 3 年 BCVA与年龄、症状持续时间、基线 BCVA、AL、手术类型、术前黄斑状态和近视性黄斑病变严重程度等一系列因素的相关性。
本研究共纳入 28 例 FS（28 只眼）和 21 例 FTMH（21 只眼）患者，均伴有黄斑脱离。所有患者均实现了视网膜复位，MH 闭合率为 76.19%。FS 患者在黄斑裂孔外加压术后 1 年，FTMH 患者在术后 2 年，BCVA 显著提高，且在其余随访期间保持稳定。术后平均 AL 下降 2.09mm。未观察到主要围手术期并发症，但有 1 例患者因难以忍受的复视而需要取出外加压装置。
硅胶海绵-钛外植体黄斑裂孔外加压术可能是治疗高度近视患者 FS 和 FTMH 的一种安全有效的手术选择。黄斑裂孔外加压术具有较高的闭合率，几乎没有复发趋势。
