Korobelnik J F, Hannouche D, Belayachi N, Branger M, Guez J E, Hoang-Xuan T
Department of Ophthalmology, Bichat-Claude Bernard hospital, Paris, France.
Ophthalmology. 1996 Apr;103(4):590-4. doi: 10.1016/s0161-6420(96)30648-9.
A pilot study was undertaken to assess the efficacy of autologous platelets in macular hole healing.
Eight eyes of eight patients with stage 3 or 4 macular holes, two of which had failed to heal after previous vitrectomy and gas tamponade, were included. The procedure consisted of pars plana vitrectomy with removal of posterior cortical vitreous, stripping of associated epimacular membranes, 15% perfluoroethane-air tamponade, and instillation of autologous platelet concentrate onto the posterior pole. Strict postoperative facedown positioning was observed for 12 days. Postoperative evaluation included visual acuity measurement, biomicroscopic macular appearance and scanning laser ophthalmoscope examination. The follow-up period ranged from 3 to 13 months (mean, 7 months).
Of eight eyes, flattening of the surrounding retina and closure of the hole were achieved in seven (87.5%). Visual acuity improved two lines or more in four eyes (50%) Four eyes (50%) reached a postoperative visual acuity of 20/50 or more. Increased nuclear sclerosis was observed in six eyes (75%), and retinal detachment occurred in two eyes (25%).
Autologous platelet concentrate administered peroperatively in full-thickness macular holes seems to be a safe and effective adjunct to vitrectomy with removal of posterior hyaloid and gas tamponade. A larger multicenter randomized prospective study is underway to verify these encouraging results before advocating the use of autologous platelets in macular hole surgery.
开展一项初步研究以评估自体血小板在黄斑裂孔愈合中的疗效。
纳入8例患有3期或4期黄斑裂孔的患者的8只眼，其中2只眼在先前玻璃体切割术和气体填塞术后未愈合。手术过程包括经平坦部玻璃体切割术，切除后皮质玻璃体，剥除相关的黄斑前膜，15%全氟乙烷 - 空气填塞，并将自体血小板浓缩液滴注到后极部。术后严格俯卧位12天。术后评估包括视力测量、生物显微镜下黄斑外观及扫描激光眼底镜检查。随访期为3至13个月（平均7个月）。
8只眼中，7只眼（87.5%）实现了周边视网膜变平及裂孔闭合。4只眼（50%）视力提高了两行或更多。4只眼（50%）术后视力达到20/50或更好。6只眼（75%）观察到核硬化增加，2只眼（25%）发生视网膜脱离。
对于全层黄斑裂孔，术中给予自体血小板浓缩液似乎是玻璃体切割术联合切除后玻璃体及气体填塞的一种安全有效的辅助方法。在倡导将自体血小板用于黄斑裂孔手术之前，正在进行一项更大规模的多中心随机前瞻性研究以验证这些令人鼓舞的结果。
