三维头高脚低位玻璃体切除术与传统显微镜下玻璃体切除术治疗视网膜前膜患者的比较。

THREE-DIMENSIONAL HEADS-UP VITRECTOMY VERSUS CONVENTIONAL MICROSCOPIC VITRECTOMY FOR PATIENTS WITH EPIRETINAL MEMBRANE.

机构信息

Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, South Korea.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea; and.

出版信息

Retina. 2023 Jun 1;43(6):1010-1018. doi: 10.1097/IAE.0000000000003762.

DOI:10.1097/IAE.0000000000003762

PMID:36763981

Abstract

PURPOSE

To investigate the efficacy and safety of 3D heads-up display (3D-HUD) vitrectomy compared with conventional microscopy (CM) vitrectomy in epiretinal membrane (ERM) surgery.

METHODS

Epiretinal membrane removal with or without internal limiting membrane (ILM) peeling was performed using a 3D-HUD or CM system. The mean changes in best-corrected visual acuity (BCVA) and in central macular thickness (CMT) and postoperative complications were assessed.

RESULTS

Baseline demographics were comparable except for the follow-up period. Both BCVA and CMT improved at the final visit (all P < 0.05). The ERM recurrence and dissociated optic nerve fiber layer (DONFL) rates were lower in the 3D group (both P < 0.05). conventional microscopic vitrectomy (odds ratio [OR] = 12.86, P = 0.02) and absence of ILM peeling (OR = 45.25, P < 0.05) were associated with ERM recurrence. In the DONFL, CM vitrectomy (OR = 1.98, <0.05) and combined phacovitrectomy (OR = 2.33, P = 0.03) were analyzed as risk factors for DONFL.

CONCLUSION

The improvement in BCVA and CMT in ERM surgery using a 3D-HUD is comparable with that of CM vitrectomy, with a significantly low rate of ERM recurrence and DONFL occurrence. Therefore, 3D vitrectomy might have an advantage for ERM surgery.

摘要

目的

研究 3D 平视显示器（3D-HUD）玻璃体切除术与传统显微镜（CM）玻璃体切除术治疗视网膜前膜（ERM）的疗效和安全性。

方法

采用 3D-HUD 或 CM 系统行 ERM 切除联合或不联合内界膜（ILM）剥除术。评估最佳矫正视力（BCVA）、中心黄斑厚度（CMT）的平均变化和术后并发症。

结果

除随访时间外，基线人口统计学数据具有可比性。末次随访时 BCVA 和 CMT 均有改善（均 P < 0.05）。3D 组 ERM 复发率和分离的视神经纤维层（DONFL）发生率较低（均 P < 0.05）。传统显微镜玻璃体切除术（比值比 [OR] = 12.86，P = 0.02）和无 ILM 剥除（OR = 45.25，P < 0.05）与 ERM 复发相关。在 DONFL 中，CM 玻璃体切除术（OR = 1.98，<0.05）和联合白内障玻璃体切除术（OR = 2.33，P = 0.03）被分析为 DONFL 的危险因素。