Roth D B, Smiddy W E, Feuer W
Bascom Palmer Eye Institute, University of Miami, Florida 33136, USA.
Ophthalmology. 1997 Dec;104(12):2047-52. doi: 10.1016/s0161-6420(97)30060-8.
The purpose of the study is to compare the results of vitreous surgery for a group of patients with chronic macular holes with a group of patients with acute-onset macular holes undergoing identical surgery.
A case-control study design was used.
The duration of symptoms of visual loss due to macular holes was greater than 1 year's duration in 11 eyes in each group consecutively operated on within a few days.
All patients underwent macular hole surgery.
Ophthalmoscopic resolution of the macular hole, improvement of 2 lines of visual acuity or greater, improvement in mean and median visual acuity, and rate of 20/40 or greater final visual acuity.
The hole resolved in 9 of 11 eyes in the chronic group and 10 of 11 eyes in the acute group. The mean (median) preoperative visual acuity was 20/151 (20/200) in the chronic group and 20/139 (20/200) in the acute group. The 3-month mean (median) postoperative visual acuity was 20/85 (20/80) in the chronic group and 20/62 (20/63) in the acute group. The final mean (median) postoperative visual acuity was 20/96 (20/ 100) in the chronic group and 20/48 (20/50) in the acute group (P = 0.022). The mean interval to final follow-up examination was 70 weeks for the chronic group and 44 weeks for the acute group. Five (45%) of 11 eyes with chronic holes and 8 (73%) of 11 eyes in the acute group had a final visual acuity of 2 lines or better than the preoperative visual acuity. Cataract extraction had been performed by the final follow-up examination in 7 chronic eyes (64%) and 2 acute eyes (18%).
Chronic macular holes have a similar anatomic success rate, but a poorer visual prognosis than acute holes after macular hole surgery. Vitreous surgery benefits some patients with idiopathic macular holes of greater than 1 year's duration.
本研究旨在比较一组慢性黄斑裂孔患者与一组急性黄斑裂孔患者在接受相同玻璃体手术时的手术结果。
采用病例对照研究设计。
每组连续数天内接受手术的11只眼中，因黄斑裂孔导致视力丧失的症状持续时间均超过1年。
所有患者均接受黄斑裂孔手术。
黄斑裂孔的眼底镜检查闭合情况、视力提高2行或更多、平均和中位数视力的改善情况以及最终视力达到20/40或更好的比例。
慢性组11只眼中有9只裂孔闭合，急性组11只眼中有10只裂孔闭合。慢性组术前平均（中位数）视力为20/151（20/200），急性组为20/139（20/200）。慢性组术后3个月平均（中位数）视力为20/85（20/80），急性组为20/62（20/63）。慢性组术后最终平均（中位数）视力为20/96（20/100），急性组为20/48（20/50）（P = 0.022）。慢性组至最终随访检查的平均间隔时间为70周，急性组为44周。慢性裂孔组11只眼中有5只（45%）、急性组11只眼中有8只（73%）最终视力比术前提高了2行或更多。至最终随访检查时，7只（64%）慢性眼和2只（18%）急性眼进行了白内障摘除术。
慢性黄斑裂孔在解剖学上的成功率相似，但与急性黄斑裂孔相比，黄斑裂孔手术后的视力预后较差。玻璃体手术对一些病程超过1年的特发性黄斑裂孔患者有益。
