Danielescu Ciprian, Stanca Horia Tudor, Balta Florian
Department of Ophthalmology, "Gr. T. Popa" University of Medicine and Pharmacy, Iasi 700111, Romania.
Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, Bucharest 020021, Romania.
J Ophthalmol. 2020 Feb 21;2020:3526316. doi: 10.1155/2020/3526316. eCollection 2020.
This literature review aims to provide the retina specialist with answers to patient's questions related to the management of lamellar macular holes (LMHs). Most LMHs are stable over time, but 13-21% present an anatomic decline after 18-24 months of follow-up. Nineteen point five percent of the eyes may experience a visual acuity (VA) loss of more than 5 letters after 3 years. Many surgeons choose to perform surgery when there is significant metamorphopsia or documented decline in VA over time. The typical surgery is phacovitrectomy with the epiretinal membrane and the internal limiting membrane peeling in previously phakic eyes (41.9 to 85.3% of the eyes). In the eyes that remained phakic, cataract surgery was often necessary within the first year of follow-up (19.2 to 40% of eyes). After surgery, a VA gain was recorded in 63-94% of eyes, but some eyes (between 0 and 20%) suffered some VA loss. Progression to full-thickness macular hole may occur after surgery, and thus a second surgical intervention may be needed.
本综述旨在为视网膜专科医生提供与板层黄斑裂孔（LMH）治疗相关的患者问题的答案。大多数LMH随时间推移是稳定的，但13% - 21%的患者在随访18 - 24个月后出现解剖结构退变。19.5%的患眼在3年后可能会出现视力（VA）下降超过5行。当出现明显的视物变形或记录到VA随时间下降时，许多外科医生会选择进行手术。典型的手术是在既往有晶状体眼的患者中进行晶状体玻璃体切除术，并剥除视网膜前膜和内界膜（41.9%至85.3%的患眼）。在仍有晶状体的患眼中，随访的第一年通常需要进行白内障手术（19.2%至40%的患眼）。手术后，63% - 94%的患眼记录到VA提高，但一些患眼（0%至20%）出现了一定程度的VA下降。手术后可能会进展为全层黄斑裂孔，因此可能需要进行二次手术干预。
