覆盖角膜基质透镜治疗病理性近视黄斑裂孔

Covering corneal stromal lenticule for macular hole in pathological myopia.

作者信息

Tang Zi-Yan, Qiao Gang, Zhang Xiao-Juan, Xie Li-Jun, Zou Qiang-Xing, He Chun-Mei, Zhao Long, Yang Hua-Qing, Quan Yu, Cao Kui, Jiang Hui, He Yu-Kun

机构信息

Wanjiang Eye Hospital of Mianyang, Mianyang 621000, Sichuan Province, China.

出版信息

Int J Ophthalmol. 2024 Sep 18;17(9):1675-1680. doi: 10.18240/ijo.2024.09.15. eCollection 2024.

Abstract

AIM

To evaluate the clinical effect of a new surgery technique (covering corneal stromal lenticule, CSL) for macular hole (MH) in pathological myopia.

METHODS

This was a prospective non-randomized series case study. Fourteen eyes of 14 patients whose axial length were more than 29 mm and suffered from MH and macular hole retinal detachment (MHRD) were included in this study. All cases were treated with 25-gauge pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, covering CSL and CF gas tamponade. These cases were followed for 6mo, and the best-corrected visual acuity (BCVA), healing status of MH, the reattached rate of retinal detachment (RD), and reoperation rate were analyzed.

RESULTS

All cases were successfully performed the surgery and the postoperative follow-up was completed. After surgery, MHs were healed in all 14 eyes (100%, 14/14) after assessed by optical coherence tomography. The reattachment of retina was achieved in all 6 eyes (100%, 6/6) with MHRD. BCVA was improved in 12 eyes (85.71%, 12/14), and had no significant change in 2 eyes (14.29%, 2/14). The overall mean BCVA was improved from 1.80±0.77 to 0.82±0.46 logMAR (=10.46, <0.01). No serious complications occurred in all cases.

CONCLUSION

The new surgery technique (covering CSL) has high reattached rate of RD and high healing rate of MH in pathological myopia in the preliminary study. And it can effectively improve the visual function of patients. This new technique offers meaningful new ideas for treating refractory MH in pathological myopia.

摘要

目的

评估一种新的手术技术(覆盖角膜基质透镜,CSL)治疗病理性近视黄斑裂孔(MH)的临床效果。

方法

这是一项前瞻性非随机系列病例研究。本研究纳入了14例患者的14只眼,这些患者眼轴长度超过29mm,患有MH和黄斑裂孔性视网膜脱离(MHRD)。所有病例均接受25G经平坦部玻璃体切除术(PPV),联合内界膜(ILM)剥除、覆盖CSL及空气填充性气体填塞。对这些病例进行6个月的随访,分析最佳矫正视力(BCVA)、MH愈合情况、视网膜脱离(RD)复位率及再次手术率。

结果

所有病例均成功完成手术并完成术后随访。术后经光学相干断层扫描评估,14只眼中的MH均愈合(100%,14/14)。6只患有MHRD的眼中视网膜均复位(100%,6/6)。12只眼(85.71%,12/14)的BCVA得到改善,2只眼(14.29%,2/14)无明显变化。总体平均BCVA从1.80±0.77提高至0.82±0.46 logMAR(=10.46,<0.01)。所有病例均未发生严重并发症。

结论

在初步研究中,新的手术技术(覆盖CSL)治疗病理性近视的RD复位率高、MH愈合率高。并且它能有效改善患者的视功能。这项新技术为治疗病理性近视难治性MH提供了有意义的新思路。

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