Paques M, Massin P, Santiago P Y, Spielmann A C, Gaudric A
Service d'Ophtalmologie, Hôpital Latiboisière, Université Paris VII, Paris, France.
Am J Ophthalmol. 1997 Jul;124(1):88-94. doi: 10.1016/s0002-9394(14)71648-4.
To report the results of a prospective study of the incidence of peripheral visual field loss after macular hole surgery.
Prospectively, 30 eyes of 30 consecutive patients with full-thickness macular holes operated on between December 1995 and April 1996 had preoperative and postoperative Goldmann visual field tests. The surgical procedure consisted of three-port pars plana vitrectomy, posterior hyaloid removal, nonexpansile fluid-hexafluoroethane (C2F6) exchange, and, in 19 of 30 patients, autologous platelet injection, followed by face-down positioning.
Twenty-nine of these 30 cases were considered to be anatomic successes. Comparison of preoperative and postoperative visual fields disclosed that four patients (13%) had a peripheral scotoma, including one patient with stage 4 macular hole. Three other patients (10%) had a postoperative relative arcuate defect. Mean postoperative intraocular pressure was higher in the latter group. None of the patients complained of peripheral scotoma.
Overall, seven of 30 patients (23%) had a postoperative visual field defect. Two categories of scotomas were observed: peripheral and relative arcuate. The cause of peripheral visual field loss is unclear. Increased intraocular pressure may be the cause of relative arcuate scotomas.
报告一项关于黄斑裂孔手术后周边视野缺损发生率的前瞻性研究结果。
前瞻性地，对1995年12月至1996年4月间连续30例接受全层黄斑裂孔手术的患者的30只眼进行术前和术后的Goldmann视野检查。手术过程包括三通道玻璃体切除术、后玻璃体皮质切除、非膨胀性液体-六氟乙烷（C2F6）置换，30例患者中有19例进行了自体血小板注射，随后采取面朝下体位。
这30例患者中有29例被认为解剖学上成功。术前和术后视野比较显示，4例患者（13%）出现周边暗点，其中包括1例4期黄斑裂孔患者。另外3例患者（10%）术后出现相对弓形缺损。后一组患者术后平均眼压较高。所有患者均未主诉周边暗点。
总体而言，30例患者中有7例（23%）术后出现视野缺损。观察到两类暗点：周边暗点和相对弓形暗点。周边视野缺损的原因尚不清楚。眼压升高可能是相对弓形暗点的原因。
