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玻璃体黄斑牵引综合征行玻璃体后皮质剥除的玻璃体切除术的长期结果:中亚人群的前瞻性研究

Long-Term Results of Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Vitreomacular Traction Syndrome: A Prospective Investigation in Central Asian Population.

作者信息

Zhurgumbayeva Gulnar, Kyrykbayev Dastan, Ruslanuly Kairat, Binder Susanne, Kulmaganbetov Mukhit

机构信息

Kazakh Eye Research Institute, Almaty A05H2A8, Kazakhstan.

Department of Ophthalmology, Sigmund Freud University, 1020 Vienna, Austria.

出版信息

Healthcare (Basel). 2024 Dec 30;13(1):44. doi: 10.3390/healthcare13010044.

DOI:10.3390/healthcare13010044
PMID:39791651
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11720311/
Abstract

There is a lack of research on the clinical characteristics of vitreomacular traction (VMT) in the Central Asian population, which evaluates the visual recovery and macular hole closure outcomes of pars plana vitrectomy (PPV) with membrane peel in this population. This long-term prospective cohort study, conducted at the Kazakh Eye Research Institute from June 2015 to December 2021 with a follow-up period until December 2022, included 1574 patients (1784 eyes) with VMT syndrome. Among the eyes, 724 (40.58%) had VMT, 620 (34.75%) had a lamellar macular hole (LMH), and 440 (24.66%) had a full-thickness macular hole (FTMH). The FTMH group consisted of small (≤250 μm) holes in 14 (3.2%) eyes, medium (250-400 μm) holes in 79 (17.9%) eyes, and large (>400 μm) holes in 347 (78.9%) eyes. Significant improvements in visual acuity, retinal thickness reduction, and macular hole closure were observed in 98.79% of patients with LMH and 81.14% of patients with FTMH at 1.5 months after surgery. PPV with membrane peel resulted in improved clinical outcomes, including enhanced visual acuity and macular structure. These findings support the existing research indicating the efficacy and relative safety of this surgical approach for VMT, despite the potential risks of postoperative complications.

摘要

中亚人群玻璃体黄斑牵引(VMT)临床特征的研究较少,本研究评估了该人群行玻璃体后皮质剥除的玻璃体切除术(PPV)后的视力恢复和黄斑裂孔闭合情况。这项长期前瞻性队列研究于2015年6月至2021年12月在哈萨克斯坦眼科研究所进行,随访期至2022年12月,纳入了1574例VMT综合征患者(1784只眼)。其中,724只眼(40.58%)患有VMT,620只眼(34.75%)患有板层黄斑裂孔(LMH),440只眼(24.66%)患有全层黄斑裂孔(FTMH)。FTMH组中,14只眼(3.2%)为小孔(≤250μm),79只眼(17.9%)为中等大小孔(250 - 400μm),347只眼(78.9%)为大孔(>400μm)。术后1.5个月时,98.79%的LMH患者和81.14%的FTMH患者视力显著提高,视网膜厚度降低,黄斑裂孔闭合。玻璃体后皮质剥除的PPV改善了临床结局,包括提高了视力和改善了黄斑结构。这些发现支持了现有研究,表明尽管该手术方法存在术后并发症的潜在风险,但对VMT是有效且相对安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aa3/11720311/8b4feed63c8d/healthcare-13-00044-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aa3/11720311/47859611bb3c/healthcare-13-00044-g001.jpg
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本文引用的文献

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Impact of phacoemulsification on posterior vitreous detachment formation in eyes with vitreomacular traction.超声乳化白内障吸除术对玻璃体黄斑牵引眼中后玻璃体脱离形成的影响。
Digit J Ophthalmol. 2023 Jun 8;29(2):26-30. doi: 10.5693/djo.01.2023.04.001. eCollection 2023.
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Amniotic Membrane Transplantation for Macular Hole Closure.羊膜移植治疗黄斑裂孔闭合术
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大黄斑裂孔的手术分类:基于不同手术技术的结果:CLOSE研究组
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Clin Ophthalmol. 2022 Jul 11;16:2235-2243. doi: 10.2147/OPTH.S367431. eCollection 2022.
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Efficacy and Safety of Ocriplasmin Use for Vitreomacular Adhesion and Its Predictive Factors: A Systematic Review and Meta-Analysis.玻璃体内注射奥克纤溶酶治疗玻璃体黄斑粘连的疗效与安全性及其预测因素:一项系统评价与Meta分析
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