Bair Henry, Kung Wei-Hsun, Lai Chun-Ting, Lin Chun-Ju, Chen Huan-Sheng, Chang Cheng-Hsien, Lin Jane-Ming, Hsia Ning-Yi, Chen Wen-Lu, Tien Peng-Tai, Wu Wen-Chuan, Tsai Yi-Yu
Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Stanford University School of Medicine, Stanford, CA, USA.
Clin Ophthalmol. 2021 Feb 24;15:807-814. doi: 10.2147/OPTH.S294690. eCollection 2021.
To evaluate the efficacy of micro-incision vitrectomy surgery using a non-contact wide-angle viewing system for fovea-attached type epiretinal membrane, and to report the factors influencing the outcome.
A retrospective, comparative case series that included 50 patients with fovea-attached type epiretinal membrane who received micro-incision vitrectomy surgery using a non-contact wide-angle viewing system.
All patients were followed-up for a minimum of 12 months. Seven cases were classified as group 1A (mainly outer retinal thickening), 17 were group 1B (more tenting of outer retina and distorted inner retina), and 26 were group 1C (prominent inner retina thickening and inward tenting of outer retina). Outcome measures included operation time, recurrent rate, postoperative BCVA, and CRT. The mean operative time was 26.2 minutes. The mean change of BCVA (LogMAR) was -0.43 (p< 0.001). The mean change of CRT was 135.3 μm (p< 0.001). The mean change of CRT was significantly higher in group 1C. Worse preoperative BCVA, male gender, and longer operative time can predict better postoperative BCVA found by multivariate logistic regression and multiple regression models.
Significant improvement in BCVA and CRT is noted after micro-incision vitrectomy surgery to operate fovea-attached type epiretinal membranes. Worse preoperative BCVA, male, and longer operation time could predict better improvement. These findings may assist surgeons in better evaluating the potential of this method to help their patients with epiretinal membranes.
评估使用非接触广角观察系统的微创玻璃体切除术治疗黄斑附着型视网膜前膜的疗效,并报告影响手术结果的因素。
一项回顾性、比较性病例系列研究,纳入50例接受使用非接触广角观察系统的微创玻璃体切除术的黄斑附着型视网膜前膜患者。
所有患者均至少随访12个月。7例被归类为1A组(主要为外层视网膜增厚),17例为1B组(外层视网膜更多呈帐篷样改变且内层视网膜扭曲),26例为1C组(显著的内层视网膜增厚及外层视网膜向内呈帐篷样改变)。观察指标包括手术时间、复发率、术后最佳矫正视力(BCVA)和中心视网膜厚度(CRT)。平均手术时间为26.2分钟。BCVA(LogMAR)的平均变化为-0.43(p<0.001)。CRT的平均变化为135.3μm(p<0.001)。1C组CRT的平均变化显著更高。多因素逻辑回归和多元回归模型显示,术前BCVA较差、男性性别和手术时间较长可预测术后BCVA改善较好。
微创玻璃体切除术治疗黄斑附着型视网膜前膜后,BCVA和CRT有显著改善。术前BCVA较差、男性及手术时间较长可预测改善效果更好。这些发现可能有助于外科医生更好地评估该方法对视网膜前膜患者的治疗潜力。