Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, 69# North Dongxia Road, Jinping District, Shantou, Guangdong, 515041, P.R. China.
BMC Ophthalmol. 2022 Nov 18;22(1):444. doi: 10.1186/s12886-022-02679-2.
Vitrectomy and peeling of the internal limiting membrane (ILM) was an effective therapeutic approach for myopic foveoschisis with progressive visual loss. This study investigated the anatomical and visual outcomes of fovea-sparing ILM peeling with or without the inverted flap technique for patients with symptomatic myopic foveoschisis (MF).
We retrospectively reviewed the clinical data of patients with MF. Vitrectomy with fovea-sparing ILM peeling and air tamponade was performed in all patients. The primary outcome measures included best-corrected visual acuity (BCVA), mean macular thickness (MMT), and central foveal thickness (CFT). Depending on whether an inverted ILM flap technique was utilized, further subgroup comparisons between the inverted flap group and the non-inverted flap group were conducted.
Twenty-six eyes of 22 patients were included. Fifteen eyes were underwent fovea-sparing ILM peeling without inverted ILM flap and 11 of the 26 eyes were treated with fovea-sparing ILM peeling and an inverted ILM flap technique. In the mean follow-up period of 10.74 ± 4.58 months, a significant improvement in BCVA was observed from 0.97 ± 0.45 logMAR to 0.58 ± 0.51 logMAR (P < 0.01), during which the BCVA of 20 eyes (76.92%) improved and remained stable in 5 eyes (19.23%). Moreover, a positive correlation was also found between the preoperative BCVA and the postoperative BCVA (r = 0.50, P = 0.01). At the last visit, the final MMT decreased from 492.69 ± 209.62 μm to 234.73 ± 86.09 μm, and the CFT reduced from 296.08 ± 209.22 μm to 138.31 ± 73.92 μm (all P < 0.01). A subgroup analysis found no significant differences in BCVA, MMT, or CFT between the inverted and non-inverted flap groups (all P > 0.05).
Fovea-sparing ILM peeling with or without inverted flap technique resulted in favorable visual and anatomical outcomes for the treatment of MF. An important factor affecting the postoperative visual outcome was the preoperative visual acuity. Our study found no significant difference between the presence and absence of the inverted ILM flap.
玻璃体切割联合内界膜（ILM）剥除术是治疗伴有进行性视力丧失的近视性黄斑裂孔的有效治疗方法。本研究旨在探讨对于有症状的近视性黄斑裂孔（MF）患者，保留黄斑区的内界膜剥除术联合或不联合内界膜翻转瓣技术的解剖和视力结果。
回顾性分析 MF 患者的临床资料。所有患者均行玻璃体切割联合保留黄斑区的内界膜剥除术及空气填充。主要观察指标包括最佳矫正视力（BCVA）、平均黄斑厚度（MMT）和中心视网膜厚度（CFT）。根据是否应用内界膜翻转瓣技术，进一步对翻转瓣组和非翻转瓣组进行亚组比较。
共纳入 22 例（26 只眼）患者。15 只眼行保留黄斑区的内界膜剥除术，不联合内界膜翻转瓣；11 只眼行保留黄斑区的内界膜剥除术联合内界膜翻转瓣技术。平均随访时间为 10.74±4.58 个月，BCVA 从术前的 0.97±0.45 logMAR 提高到术后的 0.58±0.51 logMAR（P＜0.01），其中 20 只眼（76.92%）视力提高，5 只眼（19.23%）视力稳定。此外，术前 BCVA 与术后 BCVA 呈正相关（r=0.50，P=0.01）。末次随访时，MMT 从术前的 492.69±209.62μm 降至术后的 234.73±86.09μm（均 P＜0.01），CFT 从术前的 296.08±209.22μm 降至术后的 138.31±73.92μm（均 P＜0.01）。亚组分析显示，翻转瓣组与非翻转瓣组的 BCVA、MMT 或 CFT 差异均无统计学意义（均 P＞0.05）。
保留黄斑区的内界膜剥除术联合或不联合内界膜翻转瓣技术治疗 MF 可获得良好的视力和解剖学结果。影响术后视力的一个重要因素是术前视力。本研究发现内界膜翻转瓣的存在与否对预后无显著影响。
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