Department of Vitreoretina, Disha Eye Hospitals Pvt Ltd, Kolkata, West Bengal, India.
Eur J Ophthalmol. 2021 Nov;31(6):3277-3283. doi: 10.1177/1120672120979904. Epub 2020 Dec 14.
BACKGROUND/AIM: To compare the intra-operative video overlay guided enlargement of Area of ILM peeled (AIP) more than three Disc Diameter (DD) versus the inverted flap technique in large (>400 µm ) Full Thickness Macular Holes (FTMH).
Retrospectively, 127 cases of large FTMHs divided into two groups (i) Group A ( = 62)-intra-operative video-overlay guided enlargement of AIP > 3DD performed and (ii) Group B ( = 65)-Inverted flap technique was done. Mean Best Corrected Visual Acuity (BCVA), hole closure rate and postoperative foveal anatomy were noted on Optical Coherence Tomography (OCT).
Mean Minimal Diameter of Macular Hole (MDMH) were 632.05 ± 146.62 µm (A) and 677.24 ± 152.08 µm (B). Hole closure rate were 93.55% (A) and 96.92% (B). Mean preoperative BCVA was 1.07 ± 0.37 Log MAR (A) and 0.94 ± 0.23 Log MAR (B). Mean postoperative BCVA at 3 months were 0.73 ± 0.22 Log MAR (A) and 0.83 ± 0.24 Log MAR (B). One-way ANOVA test showed statistically better visual improvement in Group A at 3 months ( = 0.02), 6 months ( = 0.045), 12 months ( = 0.002), and 24 months ( = 0.011). Chi square test revealed Type I pattern of hole closure was statistically more in Group B ( < 0.001). Delayed Recovery of Outer Retinal Layers was more in group B (Pearson Chi square test, = 0.039).
Anatomically, macular hole closure rate as well as closure pattern was better in Group B. But functional improvement was better in Group A.
背景/目的：比较术中视频叠加引导下扩大内界膜剥离面积（AIP）超过三个视盘直径（DD）与倒置瓣技术在大（>400μm）全层黄斑裂孔（FTMH）中的应用。
回顾性分析 127 例大 FTMH 患者，分为两组：（i）A 组（n=62）-行术中视频叠加引导下扩大 AIP>3DD；（ii）B 组（n=65）-行倒置瓣技术。采用光学相干断层扫描（OCT）观察最佳矫正视力（BCVA）、裂孔闭合率和术后黄斑解剖结构。
平均黄斑孔最小直径（MDMH）分别为 632.05±146.62μm（A）和 677.24±152.08μm（B）。裂孔闭合率分别为 93.55%（A）和 96.92%（B）。术前平均 BCVA 分别为 1.07±0.37 LogMAR（A）和 0.94±0.23 LogMAR（B）。术后 3 个月平均 BCVA 分别为 0.73±0.22 LogMAR（A）和 0.83±0.24 LogMAR（B）。单因素方差分析显示，A 组术后 3 个月（ = 0.02）、6 个月（ = 0.045）、12 个月（ = 0.002）和 24 个月（ = 0.011）的视力改善有统计学意义。卡方检验显示，B 组Ⅰ型裂孔闭合的比例明显更高（ < 0.001）。B 组外层视网膜延迟恢复的比例更高（皮尔逊卡方检验， = 0.039）。
在解剖学上，B 组的黄斑裂孔闭合率和闭合模式更好，但 A 组的功能改善更好。
