Wang Hua, Ji Meng, Di Rong, Qi Yun, Pei Cheng, Gao Shan, Liu Si-Wei, Xie An-Ming, Cheng Yu-Hong
Department of Ophthalmology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
Ankang Hospital of Traditional Chinese Medicine, Ankang 725000, Shaanxi Province, China.
Int J Ophthalmol. 2020 Nov 18;13(11):1773-1779. doi: 10.18240/ijo.2020.11.14. eCollection 2020.
To assess the efficacy and safety of parafoveal retinal massage combined with autologous whole blood cover in the treatment of refractory macular holes (MHs) and present the surgical procedure.
Patients with giant (minimum diameter ≥800 µm), recurrent or persistent MHs who underwent PPV combined with parafoveal retinal massage and autologous whole blood cover using C3F8 as tamponade agent from February 2018 to May 2019 were enrolled in this retrospective study. After surgery, all patients were informed to maintain a prone position for at least 7d. Preoperative and postoperative best-corrected visual acuities (BCVAs) were compared and MH closure rate was measured as the main outcome.
A total of 13 MH patients consisted of 6 giant MHs, 4 persistent holes and 3 recurrent holes (5 men and 8 women; average age was 56.40±11.72y) were enrolled in this study. MH closure was achieved in 11 eyes by this modified surgical technique while 2 eyes failed. Revitrectomy with autologous neurosensory retinal patch transplantations was applied for those 2 patients and then both holes were closed. No intraoperative complications were observed. BCVA improved from 1.73 logMAR to 0.74 logMAR at 6mo postoperation. There was significant difference in BCVA before versus after the surgery (<0.05). There were no adverse events occurred during the follow-up period.
With easier surgical procedure, parafoveal retinal massage combined with autologous whole blood cover is an effective addition to the surgical options for the management of refractory MHs.
评估黄斑中心凹旁视网膜按摩联合自体全血覆盖治疗难治性黄斑裂孔（MH）的疗效和安全性，并介绍手术方法。
本回顾性研究纳入了2018年2月至2019年5月期间接受玻璃体切割术（PPV）联合黄斑中心凹旁视网膜按摩及自体全血覆盖、使用C3F8作为填塞剂治疗的巨大（最小直径≥800 µm）、复发性或持续性MH患者。术后告知所有患者保持俯卧位至少7天。比较术前和术后最佳矫正视力（BCVA），并将MH闭合率作为主要观察指标。
本研究共纳入13例MH患者，其中包括6例巨大MH、4例持续性裂孔和3例复发性裂孔（5例男性和8例女性；平均年龄为56.40±11.72岁）。采用改良手术技术使11只眼的MH闭合，2只眼失败。对这2例患者进行了自体神经感觉视网膜片移植的玻璃体切除术，随后两个裂孔均闭合。未观察到术中并发症。术后6个月时BCVA从1.73 logMAR提高到0.74 logMAR。手术前后BCVA有显著差异（<0.05）。随访期间未发生不良事件。
黄斑中心凹旁视网膜按摩联合自体全血覆盖手术操作更简便，是治疗难治性MH手术选择中的一种有效补充方法。
