特发性黄斑裂孔性视网膜脱离手术中空气下内界膜剥除及瓣翻转术

Internal Limiting Membrane Peeling and Flap Inverting under Air in Large Idiopathic Macular Hole Surgery.

作者信息

Zong Yuan, Wu Kaicheng, Yu Jian, Zhou Changbo, Jiang Chunhui

机构信息

Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai 200031, China.

Key Laboratory of Myopia of State Health Ministry, Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai 200031, China.

出版信息

J Ophthalmol. 2021 Sep 24;2021:2003001. doi: 10.1155/2021/2003001. eCollection 2021.

DOI:10.1155/2021/2003001

PMID:34608417

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8487370/

Abstract

PURPOSE

To evaluate the efficacy of internal limiting membrane (ILM) peeling combined with modified flap inverting under air in the treatment of large idiopathic macular hole (MH).

METHODS

Eyes with a large idiopathic MH (minimum diameter >550 m) were included in this study. The surgical procedure included standard 23-gauge pars plana vitrectomy (PPV), ILM peeling, complete fluid-gas exchange, and ILM flap inversion under air. The patients underwent follow-up exam including optical coherence tomography (OCT) and best-corrected visual acuity (BCVA) measurement.

RESULTS

Sixteen eyes from 16 patients were included. Mean MH diameter was 681.43 ± 112.12 m. After a mean follow-up time of 6.25 ± 2.65 months, in all cases, the MH was closed, and the ILM flap could be seen at the inner surface of the fovea. U-shaped and V-shaped MH closure was achieved in 11 and 5 cases, respectively. The BCVA improved significantly from 1.49 ± 0.35 logMAR to 0.89 ± 0.35 logMAR ( < 0.05), and visual acuity of 20/100 or better was achieved in 8 eyes.

CONCLUSION

ILM flap inverting under air was helpful in improving the functional and anatomic outcomes of vitrectomy for large idiopathic MH.

摘要

目的

评估内界膜（ILM）剥除联合气下改良瓣翻转术治疗特发性大黄斑裂孔（MH）的疗效。

方法

本研究纳入特发性大MH（最小直径>550μm）患者的患眼。手术步骤包括标准的23G经平坦部玻璃体切除术（PPV）、ILM剥除、完全液-气交换和气下ILM瓣翻转。患者接受了包括光学相干断层扫描（OCT）和最佳矫正视力（BCVA）测量在内的随访检查。

结果

纳入16例患者的16只眼。平均MH直径为681.43±112.12μm。平均随访6.25±2.65个月后，所有病例的MH均闭合，在黄斑中心凹内表面可见ILM瓣。11例和5例分别实现了U形和V形MH闭合。BCVA从1.49±0.35 logMAR显著提高到0.89±0.35 logMAR（P<0.05），8只眼的视力达到20/100或更好。