Giansanti Fabrizio, Nicolosi Cristina, Barbera Giuseppe Ruben, Vicini Giulio, Lucarelli Flavia, Traniello Gradassi Edoardo, Murro Vittoria, Virgili Gianni, Bacherini Daniela
Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy.
Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy.
Diagnostics (Basel). 2024 Dec 26;15(1):27. doi: 10.3390/diagnostics15010027.
To investigate functional and anatomical outcomes after pars plana vitrectomy (PPV) for lamellar macular hole (LMH) with a long-term follow-up.
An interventional study on 14 patients (16 eyes) with LMH was conducted. The inclusion criteria included a minimum 36-month follow-up after PPV. The preoperative and postoperative best-corrected visual acuity (BCVA) and spectral domain optical coherence tomography parameters were examined.
Preoperatively, the mean BCVA was 0.46 ± 0.22 LogMAR. Epiretinal proliferation (ERP) was visible in 81.25% of eyes. Outer retinal disruption was present in 31.25% of LMH cases. The average central foveal thickness (CFT) measured 183.68 ± 61.73 microns. The mean BCVA improved at each follow-up time point: it was 0.24 ± 0.16 LogMAR at 1 month, 0.18 ± 0.15 LogMAR at 6 months, and 0.09 ± 0.11 LogMAR at the last follow-up. There was a statistically significant improvement between BCVA at 1 month and BCVA at 6 months and between BCVA at 6 months and BCVA at the last follow-up ( < 0.001). BCVA improved in all eyes, with 87.5% achieving at least 0.3 LogMAR improvement. The mean CFT at the 1-month follow-up was 211.45 ± 43.55 microns, increased to 248.81 ± 48.51 microns at 6 months, and further increased to 278.37 ± 45.50 microns at the last follow-up. Foveal contour restoration was achieved in all eyes, and those with preoperative ellipsoid zone alterations demonstrated a complete repair of the external retinal layers. No intra or postoperative complications were recorded.
In our series, PPV had a high success rate and was associated with a substantial functional improvement in LMH treatment, and this result was maintained and kept increasing until the last follow-up. Long-term follow-up is crucial for a comprehensive evaluation of the healing process and to assess the benefits of the surgical intervention.
通过长期随访，研究板层黄斑裂孔（LMH）行玻璃体切除术（PPV）后的功能和解剖学结果。
对14例（16只眼）LMH患者进行了一项干预性研究。纳入标准包括PPV术后至少36个月的随访。检查术前和术后最佳矫正视力（BCVA）以及频域光学相干断层扫描参数。
术前，平均BCVA为0.46±0.22 LogMAR。81.25%的眼中可见视网膜前增殖（ERP）。31.25%的LMH病例存在外层视网膜破坏。平均中心凹厚度（CFT）为183.68±61.73微米。在每个随访时间点，平均BCVA均有所改善：1个月时为0.24±0.16 LogMAR，6个月时为0.18±0.15 LogMAR，最后一次随访时为0.09±0.11 LogMAR。1个月时的BCVA与6个月时的BCVA之间以及6个月时的BCVA与最后一次随访时的BCVA之间存在统计学上的显著改善（<0.001）。所有眼睛的BCVA均有所改善，87.5%的眼睛至少提高了0.3 LogMAR。1个月随访时的平均CFT为211.45±43.55微米，6个月时增加到248.81±48.51微米，最后一次随访时进一步增加到278.37±45.50微米。所有眼睛均实现了黄斑轮廓恢复，术前椭圆体带改变的眼睛显示外层视网膜层完全修复。未记录术中或术后并发症。
在我们的系列研究中，PPV成功率高，与LMH治疗中功能的显著改善相关，且这一结果一直保持并持续改善直至最后一次随访。长期随访对于全面评估愈合过程和评估手术干预的益处至关重要。
