Tao Jiwei, Chen Huan, Chen Yiqi, Yu Jiangxin, Xu Jiawen, Mao Jianbo, Lin Li, Shen Lijun
Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang Province, China .
Retina. 2022 May 1;42(5):877-882. doi: 10.1097/IAE.0000000000003394.
To evaluate the efficacy of air tamponade in idiopathic macular hole (iMH) surgery and of an additional intravitreal air injection in the treatment of persistent holes.
Retrospective, observational case series. Sixty eyes of 60 patients with an iMH underwent phacoemulsification of cataract (when appropriate), pars plana vitrectomy, and internal limiting membrane peeling, followed by air tamponade. Eyes with persistent holes underwent an additional intravitreal air injection within 1 week after surgery. The iMH closure rate and the best-corrected visual acuity were evaluated.
In all 30 eyes with an iMH diameter <400 µm, the iMH closed after the primary surgery; however, only 17 of 30 eyes with an iMH diameter of ≥400 µm closed after the primary surgery. For the 13 eyes with persistent holes, an additional intravitreal air injection resulted in successful hole closure. There was no significant difference in the best-corrected visual acuity at the final follow-up between the closed subgroup and the initially unclosed subgroup after closure.
Pars plana vitrectomy combined with air tamponade effectively cured small iMHs. For large iMHs not closed after the primary surgery, an additional intravitreal air injection resulted in hole closure and achieved a good prognosis.
评估气体填塞在特发性黄斑裂孔（iMH）手术中的疗效以及额外玻璃体腔内注射气体在治疗持续性裂孔中的疗效。
回顾性观察病例系列。60例iMH患者的60只眼接受了白内障超声乳化术（如适用）、玻璃体切除术及内界膜剥除术，随后进行气体填塞。持续性裂孔的眼在术后1周内额外接受了玻璃体腔内气体注射。评估iMH闭合率和最佳矫正视力。
在所有30只iMH直径<400 µm的眼中，初次手术后iMH闭合；然而，在30只iMH直径≥400 µm的眼中，初次手术后仅17只闭合。对于13只持续性裂孔的眼，额外的玻璃体腔内气体注射导致裂孔成功闭合。最终随访时，闭合亚组与最初未闭合亚组闭合后的最佳矫正视力无显著差异。
玻璃体切除术联合气体填塞可有效治愈小的iMH。对于初次手术后未闭合的大iMH，额外的玻璃体腔内气体注射可导致裂孔闭合并取得良好预后。
