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后巩膜加固术联合玻璃体切割术治疗病理性近视性黄斑劈裂的长期疗效

Long-term outcome of pathologic myopic foveoschisis treated with posterior scleral reinforcement followed by vitrectomy.

作者信息

Huang Yao, Qi Yue, Wei Wen-Bin, Duan An-Li

机构信息

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

出版信息

Int J Ophthalmol. 2022 Jun 18;15(6):975-982. doi: 10.18240/ijo.2022.06.16. eCollection 2022.

Abstract

AIM

To report the long-term outcome of posterior scleral reinforcement (PSR) followed by vitrectomy for pathologic myopic foveoschisis (MF).

METHODS

The records of 27 patients (44 eyes) treated with posterior scleral reinforcement (PSR) followed by vitrectomy for pathologic MF were retrospectively reviewed. The best-corrected visual acuity (BCVA), refractive error, axial length, and spectral-domain optical coherence tomography findings and complications were analyzed.

RESULTS

Forty-four eyes of 27 patients were included in this study. The follow-up period was 47.98±18.23mo (24-83mo). The mean preoperative BCVA (logMAR) was 1.13±0.63, and the mean postoperative BCVA was 0.30±0.33 at the last visit. There showed a significant improvement in BCVA postoperatively (<0.001). Postoperative BCVA in 41 eyes (93%) was improved compared with the preoperative one. Forty-two eyes (95.45%) got total resolution of the MF after surgery. The remaining two eyes (4.55%) got partial resolution of foveoschisis. The preoperative foveal thickness was 610.45±217.11 µm and the postoperative foveal thickness at the last visit was significantly reduced to 177.64±55.40 µm (<0.001). The preoperative axial length was 29.60±1.71 mm, and the postoperative axial length was 29.74±1.81 mm at the last visit. There was no significant increase in axial length within 47.98±18.23mo of follow-up (=0.562). There was no recurrence of foveoschisis or occurrence of full-thickness macular hole during the whole follow-up period.

CONCLUSION

For pathologic MF, PSR followed by vitrectomy is an effective procedure to improve the visual acuity and the anatomical structure of macula. It can also stabilize the axial length for a long time.

摘要

目的

报告后巩膜加固术(PSR)联合玻璃体切除术治疗病理性近视性黄斑劈裂(MF)的长期疗效。

方法

回顾性分析27例(44只眼)接受后巩膜加固术联合玻璃体切除术治疗病理性MF患者的病历。分析最佳矫正视力(BCVA)、屈光不正、眼轴长度、频域光学相干断层扫描结果及并发症。

结果

本研究纳入27例患者的44只眼。随访时间为47.98±18.23个月(24 - 83个月)。末次随访时,术前平均BCVA(logMAR)为1.13±0.63,术后平均BCVA为0.30±0.33。术后BCVA有显著改善(<0.001)。41只眼(93%)术后BCVA较术前提高。42只眼(95.45%)术后黄斑劈裂完全消退。其余2只眼(4.55%)黄斑劈裂部分消退。术前黄斑中心凹厚度为610.45±217.11 µm,末次随访时术后黄斑中心凹厚度显著降至177.64±55.40 µm(<0.001)。术前眼轴长度为29.60±1.71 mm,末次随访时术后眼轴长度为29.74±1.81 mm。在47.98±18.23个月的随访期内,眼轴长度无显著增加(=0.562)。整个随访期间未发生黄斑劈裂复发或全层黄斑裂孔。

结论

对于病理性MF,后巩膜加固术联合玻璃体切除术是提高视力和改善黄斑解剖结构的有效方法。它还能长期稳定眼轴长度。

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