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Descemet膜移植治疗复发性高度近视黄斑裂孔伴视网膜脱离:用于近视黄斑裂孔的Descemet膜

Descemet's membrane transplantation for the treatment of recurrent high myopic macular hole associated with retinal detachment : Descemet's membrane for myopic macular hole.

作者信息

Gürelik İhsan Gökhan, Özdemir Hüseyin Baran, Acar Ahmet Burak, Aydın Bahri

机构信息

Ophthalmology Department, Gazi University School of Medicine, Besevler, 06500, Ankara, Turkey.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2025 Jan;263(1):105-110. doi: 10.1007/s00417-024-06630-7. Epub 2024 Sep 7.

Abstract

PURPOSE

To report the efficacy of Descemet's Membrane (DM) transplantation over the macular hole in patients with recurrent high myopic macular hole (HMMH) associated with retinal detachment (RD).

METHODS

Six eyes of six patients with wide posterior staphyloma including MH and recurrent HMMH associated with RD were included to this retrospective study. All patients underwent pars plana vitrectomy and DM obtained from eye bank was placed over the macular hole during the surgery. Silicone oil endotamponade was used as endotamponade and removed within 6 months following surgery. Pre-operative and post-operative ophthalmologic examination and optical coherence tomography findings were recorded.

RESULTS

The mean follow-up time was 18.53 ± 7.36 months. Macular hole closure was achieved in all patients (100%). Best-corrected visual acuity was improved from 1.51 ± 0.55 logMAR to 1.08 ± 0.50 logMAR (p = 0.043). No complications due to surgery or DM during follow-up. No DM dislocation or hole re-opening occurred after surgery.

CONCLUSION

DM transplantation during vitrectomy may be an effective treatment for the recurrent HMMH associated with RD.

KEY MESSAGES

What is known Various surgical techniques have been tried for recurrent high myopic macular hole associated with retinal detachment, but satisfactory anatomical and functional success rates have still not been achieved.

WHAT IS NEW

The study demonstrates that Descemet's membrane transplantation is a safe and effective option for treating recurrent high myopic macular hole associated with retinal detachment. This is a novel technique that may overcome the limitations of existing approaches. The findings suggest that Descemet's membrane transplantation could become a promising addition to the surgical options for recurrent high myopic macular hole associated with retinal detachment.

摘要

目的

报告Descemet膜(DM)移植治疗复发性高度近视黄斑裂孔(HMMH)合并视网膜脱离(RD)患者黄斑裂孔的疗效。

方法

本回顾性研究纳入6例患有包括黄斑裂孔和复发性HMMH合并RD的后巩膜葡萄肿患者的6只眼。所有患者均接受了玻璃体切割术,术中将从眼库获取的DM覆盖于黄斑裂孔上。使用硅油内填塞,并在术后6个月内取出。记录术前和术后的眼科检查及光学相干断层扫描结果。

结果

平均随访时间为18.53±7.36个月。所有患者(100%)黄斑裂孔均闭合。最佳矫正视力从1.51±0.55 logMAR提高到1.08±0.50 logMAR(p = 0.043)。随访期间未出现因手术或DM引起的并发症。术后未发生DM脱位或裂孔重新开放。

结论

玻璃体切割术中DM移植可能是治疗复发性HMMH合并RD的有效方法。

关键信息

已知情况:对于复发性高度近视黄斑裂孔合并视网膜脱离,已尝试多种手术技术,但仍未获得令人满意的解剖和功能成功率。

新进展

本研究表明,Descemet膜移植是治疗复发性高度近视黄斑裂孔合并视网膜脱离的一种安全有效的选择。这是一种可能克服现有方法局限性的新技术。研究结果表明,Descemet膜移植可能成为复发性高度近视黄斑裂孔合并视网膜脱离手术选择中有前景的补充方法。

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