Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, Guangdong, China
Br J Ophthalmol. 2022 Apr;106(4):582-586. doi: 10.1136/bjophthalmol-2020-317800. Epub 2021 Jan 4.
To compare the efficacy of macular buckling (MB) and pars plana vitrectomy (PPV) for full-thickness macular holes (FTMH) and associated macular detachment (MD) in highly myopic eyes.
Prospective interventional case series of eyes undergoing PPV or MB for FTMH and MD.
Best-corrected visual acuity (BCVA) at postoperative month 24. Other measured outcomes include the initial surgical success rate, macular hole closure rate and the progression of myopic maculopathy.
A total of 53 eyes from 53 participants were included in this study (26 participants receiving MB and 27 participants receiving PPV), and finally 49 eyes from 49 participants (25 participants in the MB group and 24 participants in the PPV group) were analysed. At postoperative month 24, the BCVA had improved significantly in those that underwent either MB (p<0.001) or PPV (p=0.04). The difference between the groups was not significant (p=0.653). The surgical failure rate after the primary treatment was significantly higher in the PPV group than the MB group (25.00% vs 4.00%, respectively; p=0.04). The macular closure rate was higher in the MB group compared with the PPV group, but the difference was not statistically significant (64.00% vs 58.33%, respectively; p=0.45). Myopic maculopathy development may be more severe following PPV than following MB surgery.
Patients with high myopia obtained anatomical and functional improvements from either MB or PPV. However, MB achieved a significantly higher success rate in retinal reattachment compared with PPV.
NCT03433547.
比较黄斑环扎术（MB）和玻璃体切除术（PPV）治疗高度近视性全层黄斑裂孔（FTMH）伴黄斑脱离（MD）的疗效。
前瞻性干预性病例系列研究，纳入接受 PPV 或 MB 治疗 FTMH 和 MD 的患者。
术后 24 个月的最佳矫正视力（BCVA）。其他观察指标包括初始手术成功率、黄斑裂孔闭合率和近视性黄斑病变的进展情况。
本研究共纳入 53 只眼（53 名患者），其中 26 只眼接受 MB 治疗，27 只眼接受 PPV 治疗。最终有 49 只眼（49 名患者）纳入分析，其中 25 只眼接受 MB 治疗，24 只眼接受 PPV 治疗。术后 24 个月，MB 组（p<0.001）和 PPV 组（p=0.04）的 BCVA 均有显著改善，两组间差异无统计学意义（p=0.653）。PPV 组的初次治疗后手术失败率明显高于 MB 组（分别为 25.00%和 4.00%，p=0.04）。MB 组的黄斑裂孔闭合率高于 PPV 组，但差异无统计学意义（分别为 64.00%和 58.33%，p=0.45）。与 MB 手术后相比，PPV 后近视性黄斑病变的发展可能更严重。
高度近视患者接受 MB 或 PPV 治疗后，解剖结构和功能均有改善。然而，与 PPV 相比，MB 可显著提高视网膜再附着的成功率。
NCT03433547。
