非体位性手术中倒置内界膜瓣与完全内界膜剥除术治疗大黄斑裂孔的比较
Inverted Internal Limiting Membrane Flap vs Complete Internal Limiting Membrane Peeling for Large Macular Holes in Nonposturing Surgery.
作者信息
Rahman Rubina, Sarfraz Mohammad Waseem, El-Wardani Mohamad
机构信息
Calderdale Royal Hospital, Salterhebble Hill, Halifax, UK.
出版信息
J Vitreoretin Dis. 2021 Jun 30;6(1):9-13. doi: 10.1177/24741264211022212. eCollection 2022 Jan-Feb.
PURPOSE
This study compared anatomical and functional outcomes of the inverted internal limiting membrane flap (ILMF) technique with complete ILM peeling (ILMP) in nonposturing surgery for large, full-thickness macular holes (MHs).
METHODS
This was a retrospective, comparative, single-surgeon study. Eyes with idiopathic large full-thickness MHs (minimum diameter > 400 μm) were included. A total of 46 patients including 22 ILMF cases and 24 ILMP cases were analyzed. No positioning instructions were advised postoperatively.
RESULTS
Primary hole closure was achieved in all patients (100%) in both groups. Mean logMAR visual acuity (VA) improved significantly in both groups compared with the preoperative values (ILMF: 0.60 [SD, 0.26] postoperatively, vs 0.93 [SD, 0.3] preoperatively, = .032; ILMP: 0.43 [SD, 0.22] postoperatively vs 0.83 [SD, 0.16] preoperatively, < .01). However, ILMP showed a statistically significant improvement in VA compared with ILMF ( = .02).
CONCLUSIONS
All MHs in both groups closed after surgery (100%). There was a statistically significant improvement of VA in the ILMP group compared with the ILMF group ( = .02). Not posturing after surgery did not compromise surgical success in both groups.
目的
本研究比较了在非体位性手术中，倒置内界膜瓣（ILMF）技术与完全内界膜剥除（ILMP）技术治疗大的全层黄斑裂孔（MH）的解剖学和功能学结果。
方法
这是一项回顾性、比较性、单术者研究。纳入患有特发性大的全层MH（最小直径>400μm）的眼睛。共分析了46例患者，其中22例为ILMF病例，24例为ILMP病例。术后未给出体位指导。
结果
两组所有患者（100%）均实现了原发性裂孔闭合。与术前值相比，两组的平均对数最小分辨角视力（logMAR VA）均显著提高（ILMF：术后为0.60[标准差，0.26]，术前为0.93[标准差，0.3]，P = 0.032；ILMP：术后为0.43[标准差，0.22]，术前为0.83[标准差，0.16]，P < 0.01）。然而，与ILMF相比，ILMP在视力方面显示出统计学上的显著改善（P = 0.02）。
结论
两组所有MH术后均闭合（100%）。与ILMF组相比，ILMP组的视力有统计学上的显著改善（P = 0.02）。术后不采取体位并未影响两组的手术成功率。
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