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采用粘弹分离术及术中光学相干断层扫描技术的人羊膜移植治疗黄斑裂孔

Human amniotic membrane graft with viscodissection and intraoperative OCT for macular hole repair.

作者信息

Qian Shu Yu, Saab Marc

机构信息

Faculty of Medicine, University of Sherbrooke, 3001 12 Ave N, Sherbrooke, QC, J1H 5N4, Canada.

Department of Ophthalmology, Charles LeMoyne Hospital, 3120 Taschereau Blvd, Greenfield Park, QC, J4V 2H1, Canada.

出版信息

Am J Ophthalmol Case Rep. 2025 Mar 7;38:102302. doi: 10.1016/j.ajoc.2025.102302. eCollection 2025 Jun.

Abstract

OBJECTIVE

To present the human amniotic membrane (hAM) graft with the novel addition of viscodissection and usage of intraoperative OCT as a potential approach to treating challenging macular holes and to describe the outcomes.

DESIGN

Retrospective interventional case series.

PARTICIPANTS

10 patients with large, chronic, or persistent macular holes were included in this study.

METHODS

10 eyes of 10 patients were treated using a hAM graft with viscodissection. Intraoperative OCT was utilized to assist the placement of the graft. Outcomes were monitored through clinical examinations, retinal imaging, and OCT.

RESULTS

Macular holes were closed in all 10 patients and remained so during the entirety of the follow-up periods. 9 out of 10 patients experienced an improvement in visual acuity. Mean best corrected visual acuity increased from 1.68 logMAR (20/1000) preoperative to 0.74 logMAR (20/100) at 6 months postoperative. No adverse events were observed for any of our patients.

CONCLUSIONS

The addition of viscodissection to the standard hAM graft surgery is a potential optimization that reduces risks of iatrogenic damage to the retina. Surgeons can consider including this approach as part of their arsenal to treat such macular holes.

摘要

目的

介绍一种新型的人羊膜(hAM)移植术,该术式增加了粘弹分离技术,并在术中使用光学相干断层扫描(OCT),作为治疗具有挑战性的黄斑裂孔的一种潜在方法,并描述其治疗效果。

设计

回顾性介入病例系列研究。

研究对象

本研究纳入了10例患有大的、慢性或持续性黄斑裂孔的患者。

方法

对10例患者的10只眼采用带粘弹分离技术的hAM移植术进行治疗。术中使用OCT辅助移植片的放置。通过临床检查、视网膜成像和OCT监测治疗效果。

结果

所有10例患者的黄斑裂孔均闭合,且在整个随访期间保持闭合状态。10例患者中有9例视力得到改善。平均最佳矫正视力从术前的1.68 logMAR(20/1000)提高到术后6个月的0.74 logMAR(20/100)。未观察到任何患者出现不良事件。

结论

在标准的hAM移植手术中增加粘弹分离技术是一种潜在的优化方法,可降低视网膜医源性损伤的风险。外科医生可考虑将这种方法纳入其治疗此类黄斑裂孔的手段中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/669b/11954110/4d8f61b50422/gr1.jpg

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