Polk T D, Smiddy W E, Flynn H W
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, FL, USA.
Ophthalmology. 1996 Mar;103(3):422-6. doi: 10.1016/s0161-6420(96)30676-3.
In this study, the authors apply objective measures of bilateral visual function to investigate the benefits of macular hole surgery to overall visual function.
Anatomic and visual acuity outcomes were reviewed for patients undergoing primary macular hole surgery at one institution during a 3-year period. Several measures of bilateral visual function were defined to determine the impact of surgery on bilateral visual function. Patient data were analyzed in two separate cohorts based on whether the fellow eye was normal (visual acuity > or = 20/40, fellow eye normal group) or abnormal (visual acuity <20/40, fellow eye abnormal group) at baseline to determine the effect on visual function improvement.
The rim of subretinal fluid resolved after surgery in 85% of patients and 82% gained two or more Early Treatment Diabetic Retinopathy Study lines of visual acuity. After surgery, visual acuity in the surgical eye was better than or equal to the fellow eye in 35%, and average visual impairment according to the American Medical Association Guidelines for Disability decreased from 29% to 17%. Among the FEA group, vision in the surgical eye was better than or equal to that of the fellow eye in 70%, and visual impairment was reduced from 52% to 35%.
Bilateral visual function was improved after macular hole surgery. The improvement rate was markedly better in patients with subnormal vision in the fellow eye.
在本研究中，作者应用双侧视觉功能的客观测量方法来研究黄斑裂孔手术对整体视觉功能的益处。
回顾了一家机构在3年期间接受原发性黄斑裂孔手术患者的解剖学和视力结果。定义了几种双侧视觉功能测量方法，以确定手术对双侧视觉功能的影响。根据基线时对侧眼是否正常（视力≥20/40，对侧眼正常组）或异常（视力<20/40，对侧眼异常组），将患者数据分为两个独立队列进行分析，以确定对视觉功能改善的影响。
85%的患者术后视网膜下液边缘消退，82%的患者视力提高了两条或更多早期糖尿病视网膜病变研究视力线。术后，手术眼的视力在35%的患者中优于或等于对侧眼，根据美国医学协会残疾指南，平均视觉损害从29%降至17%。在对侧眼异常组中，手术眼的视力在70%的患者中优于或等于对侧眼，视觉损害从52%降至35%。
黄斑裂孔手术后双侧视觉功能得到改善。对侧眼视力低于正常的患者改善率明显更好。
