Ophthalmology Unit, Centre Hospitalier Universitaire Charles-Nicolle, Rouen, France.
P 1.5 Group, 80, allée des Ormes, 06250, Mougins, France.
Graefes Arch Clin Exp Ophthalmol. 2022 Dec;260(12):3837-3845. doi: 10.1007/s00417-022-05739-x. Epub 2022 Jul 6.
To evaluate the surgical management, outcomes and prognostic factors of full thickness macular holes without residual internal limiting membrane (NO-ILM FTMHs).
We performed a multicenter, retrospective study of 116 NO-ILM FTMHs. Human amniotic membrane (hAM) plug, autologous ILM free flap transplantation (AILMT), and autologous retinal graft transplantation (ART) were performed in 58, 48, and 10 patients, respectively. Data were collected before and up to 12 months after surgery. The primary outcomes were hole closure and final best-corrected visual acuity (BCVA).
The final BCVA (0.78 ± 0.51 logMAR) was significantly better than and correlated with the initial BCVA (p < 0.0001 and p = 0.004, respectively). Hole closure was achieved in 92% of eyes. The minimum FTMH diameter was wider and final BCVA was lower in the ART group than in the other groups (p < 0.003 and p < 0.001, respectively). FTMHs with diameter > 680 μm had a higher closure rate with hAM than with AILMT (p = 0.02).
AILMT and hAM were the most frequently performed surgeries with both high closure rate and significant functional improvement. Preoperative BCVA was correlated with final BCVA. The minimum FTMH diameter may guide the treatment choice.
评估无残余内界膜（NO-ILM）全层黄斑裂孔的手术治疗方法、结果和预后因素。
我们进行了一项多中心回顾性研究，共纳入 116 例无残余内界膜的全层黄斑裂孔患者。58 例患者接受了人羊膜（hAM）塞治疗，48 例患者接受了自体无内界膜游离移植（AILMT），10 例患者接受了自体视网膜移植（ART）。收集术前及术后 12 个月的数据。主要观察指标为裂孔闭合和最终最佳矫正视力（BCVA）。
最终 BCVA（0.78 ± 0.51 logMAR）明显优于和相关于初始 BCVA（p < 0.0001 和 p = 0.004）。92%的眼裂孔闭合。与其他两组相比，ART 组的最小黄斑裂孔直径更宽，最终 BCVA 更低（p < 0.003 和 p < 0.001）。直径> 680μm 的黄斑裂孔采用 hAM 治疗的闭合率高于 AILMT（p = 0.02）。
AILMT 和 hAM 是最常采用的手术方法，具有较高的闭合率和显著的功能改善。术前 BCVA 与最终 BCVA 相关。最小黄斑裂孔直径可能有助于指导治疗选择。
