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视网膜外膜手术后固定稳定性和位置的变化。

CHANGES OF FIXATION STABILITY AND LOCATION AFTER EPIRETINAL MEMBRANE SURGERY.

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; and.

Beijing Ophthalmology and Visual Science Key Lab, Beijing, China.

出版信息

Retina. 2022 May 1;42(5):883-891. doi: 10.1097/IAE.0000000000003396.

DOI:10.1097/IAE.0000000000003396
PMID:34954775
Abstract

PURPOSE

This study aimed to evaluate fixation stability and position changes after epiretinal membrane (ERM) surgery.

METHODS

This is a retrospective study that included 60 consecutive eyes with idiopathic ERM. All patients received comprehensive ophthalmic examinations preoperatively and 1, 4, and 10 months postoperatively. Main outcome measures included fixation stability and position, bivariate contour ellipse area, and preferred retinal locus.

RESULTS

The number of patients with stable fixation and predominantly central fixation was increased significantly after ERM surgery (61.7 vs. 73.3%, P = 0.001; 41.7 vs. 71.7%, P = 0.037). The correlation analysis showed that the preoperative factors associated with improved postoperative fixation stability were a larger bivariate contour ellipse area value (P < 0.001), poorer visual acuity (P = 0.002), advanced stage (P = 0.002), thicker central fovea thickness (P = 0.015), and a longer preferred retinal locus-fovea distance (P = 0.025). As for the improved fixation location, the associated preoperative factors were age (P = 0.003), central fovea thickness (P = 0.044), and preferred retinal locus-fovea distance (P < 0.001).

CONCLUSION

Our observations point to the changes of fixation parameters in patients after ERM surgery. We found that patients with preoperative unstable, eccentric fixation and poor BCVA can significantly benefit from the surgery. This result indicates that even in patients with severe macular damage, the ERM surgery still has great benefits in recovering visual function.

摘要

目的

本研究旨在评估视网膜前膜(ERM)手术后的固视稳定性和位置变化。

方法

这是一项回顾性研究,纳入了 60 例特发性 ERM 连续病例。所有患者均在术前和术后 1、4、10 个月接受全面眼科检查。主要观察指标包括固视稳定性和位置、双变量轮廓椭圆面积和最佳视网膜位置。

结果

ERM 手术后,稳定固视和主要中央固视的患者数量显著增加(61.7%比 73.3%,P=0.001;41.7%比 71.7%,P=0.037)。相关性分析显示,与术后固视稳定性改善相关的术前因素包括较大的双变量轮廓椭圆面积值(P<0.001)、较差的视力(P=0.002)、较晚期(P=0.002)、较厚的中心凹厚度(P=0.015)和较长的最佳视网膜位置-中心凹距离(P=0.025)。对于改善的固视位置,相关的术前因素是年龄(P=0.003)、中心凹厚度(P=0.044)和最佳视网膜位置-中心凹距离(P<0.001)。

结论

我们的观察结果表明 ERM 手术后患者的固视参数发生了变化。我们发现术前存在不稳定、偏心固视和较差 BCVA 的患者可以从手术中显著获益。这一结果表明,即使在黄斑损伤严重的患者中,ERM 手术仍然在恢复视力功能方面具有很大的益处。

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