内界膜剥除联合硅油或空气填塞治疗高度近视性黄斑劈裂。
Internal limiting membrane peeling combined with silicone oil or air tamponade for highly myopic foveoschisis.
作者信息
Deng Jin, Sun Wen-Tao, Gong Ke, Wang Li-Ping, Li Feng-Zhi
机构信息
Xi'an People's Hospital (Xi'an Fourth Hospital), Shaanxi Eye Hospital, Affiliated People's Hospital of Northwest University, Xi'an 70004, Shaanxi Province, China.
出版信息
Int J Ophthalmol. 2024 Jun 18;17(6):1079-1085. doi: 10.18240/ijo.2024.06.13. eCollection 2024.
AIM
To compare the efficacy of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) and silicone oil or sterile air tamponade for the treatment of myopic foveoschisis (MF) in highly myopic eyes.
METHODS
This retrospective study included 48 myopic eyes of 40 patients with MF and axial lengths (ALs) ranging from 26-32 mm treated between January 2020 and January 2022. All patients were underwent PPV combined with ILM peeling followed by sterile air or silicone oil tamponade and followed up at least 12mo. Based on the features on spectral-domain optical coherence tomography (SD-OCT), the eyes were divided into the MF-only group (Group A, =15 eyes), MF with central foveal detachment group (Group B, =20 eyes), and MF with lamellar macular hole group (Group C, =13 eyes). According to AL, eyes were further divided into three groups: Group D (26.01-28.00 mm, =12 eyes), Group E (28.01-30.00 mm, =26 eyes), and Group F (30.01-32.00 mm, =10 eyes). The best-corrected visual acuity (BCVA), central foveal thickness (CFT), and complications were recorded.
RESULTS
The patients included 16 males and 24 females with the mean age of 56±9.82y. The BCVA and CFT improved in all groups after surgery (<0.01), while there was no significant difference of the CFT in Group A, B, and C postoperatively (>0.05). The intergroup differences of BCVA and CFT postoperatively were statistically significant in Group D, E, and F. Twenty eyes were injected with sterile air, and 28 eyes were injected with silicone oil for tamponade based on the AL. However, there was no statistically significant difference among Groups D, E, and F in terms of the results of sterile air or silicone oil tamponade. The mean recovery time was 5.9mo for MF patients subjected to silicone oil tamponade and 7.7mo for patients subjected to sterile air tamponade, and the difference was not statistically significant.
CONCLUSION
PPV and ILM peeling combined with silicone oil or sterile air tamponade can achieve good results for MF in highly myopic eyes with ALs≤32 mm.
目的
比较玻璃体切除术（PPV）联合内界膜（ILM）及硅油或无菌空气填塞治疗高度近视眼性黄斑劈裂（MF）的疗效。
方法
本回顾性研究纳入2020年1月至2022年1月期间治疗的40例MF患者的48只近视眼，眼轴长度（AL）为26 - 32mm。所有患者均接受PPV联合ILM剥除术，随后行无菌空气或硅油填塞，并随访至少12个月。根据频域光学相干断层扫描（SD - OCT）特征，将患眼分为单纯MF组（A组，15只眼）、伴有中心凹脱离的MF组（B组，20只眼）和伴有黄斑板层裂孔的MF组（C组，13只眼）。根据AL，将患眼进一步分为三组：D组（26.01 - 28.00mm，12只眼）、E组（28.01 - 30.00mm，26只眼）和F组（30.01 - 32.00mm，10只眼）。记录最佳矫正视力（BCVA）、中心凹厚度（CFT）及并发症情况。
结果
患者包括16例男性和24例女性，平均年龄56±9.82岁。术后所有组的BCVA和CFT均改善（P<0.01），而A组、B组和C组术后CFT无显著差异（P>0.05）。D组、E组和F组术后BCVA和CFT的组间差异有统计学意义。根据AL，20只眼注入无菌空气，28只眼注入硅油进行填塞。然而，D组、E组和F组在无菌空气或硅油填塞结果方面无统计学显著差异。硅油填塞的MF患者平均恢复时间为5.9个月，无菌空气填塞患者为7.7个月，差异无统计学意义。
结论
PPV联合ILM剥除术联合硅油或无菌空气填塞治疗AL≤32mm的高度近视眼性MF可取得良好效果。
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