Shen Yadan, Li Mengyu, Li Chunxiu, Liu Miao, Li Jie, Li Shuangle, Wang Min, Zheng Chuanzhen, Zhong Jie
Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China.
Department of Ophthalmology, the People's Hospital of Leshan, Sichuan, China.
Transl Vis Sci Technol. 2025 Sep 2;14(9):35. doi: 10.1167/tvst.14.9.35.
This study evaluates the efficacy of minimal vitrectomy for full-thickness macular hole (FTMH) repair using a triamcinolone acetonide (TA)-IVIZ patch and balanced salt solution (BSS) tamponade.
An in vitro experiment was conducted to compare the adhesiveness and stability of the TA-IVIZ patch and the TA-DisCoVisc patch. Although the clinical arm of the study was a prospective study, an interventional cohort study was then performed on 24 eyes from 23 consecutive patients with FTMH. All eyes underwent minimal vitrectomy combined with internal limiting membrane (ILM) peeling, an inverted ILM flap, TA-IVIZ patch application, and BSS tamponade, without postoperative prone positioning. Outcomes, including anatomical closure rate, best-corrected visual acuity, and intraoperative and postoperative complications, were compared with a retrospective cohort of 25 eyes from 24 patients who underwent conventional surgery involving ILM peeling and grafting, gas tamponade, and postoperative prone positioning.
The in vitro experiment demonstrated that TA-IVIZ exhibited stronger adhesion than the TA-DisCoVisc. The anatomical closure rate was comparable between groups (87.5% for TA-IVIZ vs. 92% for gas tamponade; P = 0.888), as were final best-corrected visual acuity improvements (P = 0.954) and mean postoperative intraocular pressure (P = 0.623). Notably, the TA-IVIZ group did not require postoperative prone positioning.
Minimal vitrectomy with ILM peeling, an inverted ILM flap, TA-IVIZ patch, and BSS tamponade achieves high closure rates, reduces the requirement for postoperative prone positioning, and facilitates faster visual recovery, presenting a promising alternative to conventional gas tamponade techniques.
We combined TA and IVIZ to provide an effective alternative to conventional techniques for the treatment of FTMH.
本研究评估使用曲安奈德(TA)-IVIZ贴片和平衡盐溶液(BSS)填塞进行微创玻璃体切除术修复全层黄斑裂孔(FTMH)的疗效。
进行体外实验以比较TA-IVIZ贴片和TA-DisCoVisc贴片的粘附性和稳定性。尽管该研究的临床部分是一项前瞻性研究,但随后对23例连续的FTMH患者的24只眼进行了干预性队列研究。所有眼睛均接受了微创玻璃体切除术,联合内界膜(ILM)剥除、ILM瓣翻转、TA-IVIZ贴片应用和BSS填塞,术后不采用俯卧位。将包括解剖学闭合率、最佳矫正视力以及术中和术后并发症在内的结果,与24例接受传统手术(包括ILM剥除和移植、气体填塞以及术后俯卧位)的患者的25只眼的回顾性队列进行比较。
体外实验表明,TA-IVIZ的粘附力比TA-DisCoVisc更强。两组之间的解剖学闭合率相当(TA-IVIZ组为87.5%,气体填塞组为92%;P = 0.888),最终最佳矫正视力的改善情况(P = 0.954)和术后平均眼压(P = 0.623)也是如此。值得注意的是,TA-IVIZ组术后不需要俯卧位。
采用ILM剥除、ILM瓣翻转、TA-IVIZ贴片和BSS填塞的微创玻璃体切除术可实现高闭合率,减少术后俯卧位的需求,并促进视力更快恢复,是传统气体填塞技术的一个有前景的替代方法。
我们将TA和IVIZ联合起来,为FTMH的治疗提供了一种有效的传统技术替代方法。