玻璃体切割联合内界膜剥除及气体填充治疗近视性黄斑劈裂

Vitrectomy with internal limiting membrane peeling and gas tamponade for myopic foveoschisis.

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.

Department of Ophthalmology, Cangzhou Central Hospital, Hebei, China.

出版信息

BMC Ophthalmol. 2022 May 12;22(1):214. doi: 10.1186/s12886-022-02376-0.

DOI:10.1186/s12886-022-02376-0

PMID:35549885

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9097353/

Abstract

BACKGROUND

We evaluated the effect of vitrectomy with internal limiting membrane (ILM) peeling and gas tamponade for myopic foveoschisis (MF), and analysed prognosis with different gas tamponade.

METHODS

Retrospective, non-randomized study. The records of patients with MF treated by vitrectomy, were reviewed. Patients were followed up postoperatively mean 16.74 months, to record changes of Best-corrected visual acuity (BCVA) and central foveal thickness (CFT).

RESULTS

Sixty-two eyes (59 patients) were analysed in total, with mean age of 55.29 ± 10.34 years, 49 females (83.1%). Foveoschisis completely resolved in all eyes at least 6 months post vitrectomy, except for two postoperative full-thickness macular holes (FTMH). Final BCVA improved significantly from 0.69 ± 0.39 to 0.44 ± 0.42 logMAR, and CFT from 502.47 ± 164.78 to 132.67 ± 52.26 μm. Patients were subdivided into three subgroups based on the different endotamponades used (C3F8, C2F6, and air). Baseline BCVA, baseline CFT and foveal detachment (FD) were not significantly different among the three groups. Eyes treated with air tamponade had better visual outcomes than eyes with C3F8 tamponade (P = 0.008). Baseline BCVA and FD were significant risk factors for postoperative BCVA (P < 0.001 and P = 0.013, respectively).

CONCLUSIONS

Vitrectomy with ILM peeling and gas tamponade results in good functional and anatomic outcomes in the treatment of most MF. Good vision and no-FD pre-surgery are related with good visual prognosis. Air tamponade can provide as good visual recovery as expansive gas, and reduce postoperative complications.

摘要

背景

我们评估了玻璃体切割联合内界膜（ILM）剥除和气体填充治疗近视性黄斑劈裂（MF）的效果，并分析了不同气体填充的预后。

方法

回顾性、非随机研究。回顾性分析了接受玻璃体切割术治疗 MF 的患者的病历。术后平均随访 16.74 个月，记录最佳矫正视力（BCVA）和中心黄斑厚度（CFT）的变化。

结果

共分析了 62 只眼（59 例），平均年龄 55.29±10.34 岁，女性 49 例（83.1%）。除 2 例术后出现全层黄斑裂孔（FTMH）外，所有眼在玻璃体切除术后至少 6 个月黄斑劈裂完全愈合。最终 BCVA 从 0.69±0.39 提高到 0.44±0.42 logMAR，CFT 从 502.47±164.78 降低到 132.67±52.26μm。根据使用的不同内填充剂（C3F8、C2F6 和空气）将患者分为三组。三组间基线 BCVA、基线 CFT 和黄斑脱离（FD）无显著差异。与 C3F8 填充组相比，空气填充组的视力结果更好（P=0.008）。基线 BCVA 和 FD 是术后 BCVA 的显著危险因素（P<0.001 和 P=0.013）。