von Goscinski C, Gözlügöl N, Schick T, Schöneberger V, Gietzelt C, Altay L, Cursiefen C, Schaub F
MVZ Augenärztliches Diagnostik- und Therapiezentrum Mönchengladbach/Erkelenz GmbH, Erkelenz, Deutschland.
Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland.
Ophthalmologie. 2024 Sep;121(9):746-752. doi: 10.1007/s00347-024-02100-x. Epub 2024 Aug 8.
Full-thickness macular hole (FTMH) is a rare disease. Not all FTMHs can be closed by primary surgical intervention.
This work aims to characterize a large patient population with FTMHs and to detect possible predictive factors for anatomical treatment success.
The study comprises a retrospective analysis of all consecutive idiopathic macular holes between March 2008 and June 2019 at the University Eye Hospital Cologne. Epidemiologic data, preoperative parameters (size of the FTMH), and surgical technique were examined in relation to the closure rate following primary surgery.
The anatomical closure rate for idiopathic FTMH after primary surgery was 83.6%. No association between age, gender, and lens status and closure rate could be shown. Regarding anatomical surgical success, the favorable prognostic factors identified were a small FTMH size, short symptom duration, performance of transconjunctival 23-gauge vitrectomy, and application of the inverted flap technique of the internal limiting membrane (ILM).
Surgical treatment represents a valuable treatment option for patients with macular holes due to good prospects of success. Prompt intervention after diagnosis using 23-gauge vitrectomy and an ILM flap with gas tamponade seems to result in the most favorable outcomes.
全层黄斑裂孔（FTMH）是一种罕见疾病。并非所有的全层黄斑裂孔都能通过初次手术干预闭合。
这项研究旨在对大量全层黄斑裂孔患者进行特征分析，并检测解剖学治疗成功的可能预测因素。
该研究对科隆大学眼科医院2008年3月至2019年6月期间所有连续性特发性黄斑裂孔进行回顾性分析。研究了流行病学数据、术前参数（全层黄斑裂孔大小）和手术技术与初次手术后闭合率的关系。
初次手术后特发性全层黄斑裂孔的解剖学闭合率为83.6%。未发现年龄、性别、晶状体状态与闭合率之间存在关联。关于解剖学手术成功，确定的有利预后因素为全层黄斑裂孔尺寸小、症状持续时间短、经结膜23G玻璃体切除术以及应用内界膜（ILM）翻转瓣技术。
由于手术成功前景良好，手术治疗是黄斑裂孔患者的一种有价值的治疗选择。诊断后立即采用23G玻璃体切除术和ILM瓣联合气体填塞进行干预似乎能取得最理想的效果。
