Nishitsuka Koichi, Nishi Katsuhiro, Namba Hiroyuki, Kaneko Yutaka, Yamashita Hidetoshi
Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata, Japan.
Clin Optom (Auckl). 2021 Apr 14;13:113-118. doi: 10.2147/OPTO.S305927. eCollection 2021.
This study aimed to observe intraoperative changes in macular hole (MH) form using intraoperative optical coherence tomography (iOCT).
A total of 10 eyes from 10 patients with MH who underwent vitrectomy using iOCT from May 2015 to October 2015 at the Yamagata University Hospital were retrospectively evaluated. Accordingly, 25-gauge pars plana vitrectomy using iOCT with internal limiting membrane (ILM) peeling and sulfur hexafluoride gas tamponade was performed on each patient. During surgery, MHs were observed using iOCT over four points, namely, before posterior vitreous detachment (PVD) formation, after PVD formation, after ILM peeling, and after fluid-gas exchange. Thereafter, basal MH diameter and minimum aperture MH diameter were postoperatively analyzed.
Before PVD formation, after PVD formation, after ILM peeling, and after fluid-gas exchange, the mean basal MH diameters were 690.7 ± 268.4, 683.3 ± 274.2, 683.7 ± 269.5, and 668.3 ± 261.4 μm, while the mean minimum aperture MH diameters were 278.3 ± 165.2, 283.0 ± 170.2, 257.0 ± 127.8, and 188.0 ± 105.0 μm, respectively. The mean minimum aperture MH diameter decreased significantly after fluid-gas exchange (one-way repeated measures ANOVA, p < 0.05). None of the patients exhibited intraoperative closure of the MHs. However, MH closure was confirmed in all patients after the surgery.
None of the patients demonstrated intraoperative MHs closure. Accordingly, the minimum aperture MH diameter was the first change formation to close after fluid-gas exchange.
本研究旨在使用术中光学相干断层扫描(iOCT)观察黄斑裂孔(MH)形态的术中变化。
回顾性评估2015年5月至2015年10月在山形大学医院接受iOCT辅助玻璃体切除术的10例MH患者的10只眼睛。相应地,对每位患者进行25G经平坦部玻璃体切除术,术中使用iOCT并进行内界膜(ILM)剥除和六氟化硫气体填塞。手术过程中,在四个时间点使用iOCT观察MH,即玻璃体后脱离(PVD)形成前、PVD形成后、ILM剥除后以及液气交换后。术后分析MH的基底直径和最小孔径直径。
在PVD形成前、PVD形成后、ILM剥除后以及液气交换后,MH的平均基底直径分别为690.7±268.4、683.3±274.2、683.7±269.5和668.3±261.4μm,而平均最小孔径直径分别为278.3±165.2、283.0±170.2、257.0±127.8和188.0±105.0μm。液气交换后,平均最小孔径直径显著减小(单向重复测量方差分析,p<0.05)。所有患者术中均未出现MH闭合。然而,术后所有患者均确认MH闭合。
所有患者术中均未出现MH闭合。因此,最小孔径直径是液气交换后第一个闭合的形态变化。