中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2012年
7期
485-487
,共3页
陈楠%王强%张珊珊%原公强
陳楠%王彊%張珊珊%原公彊
진남%왕강%장산산%원공강
黄斑孔%外伤性%玻璃体切除术
黃斑孔%外傷性%玻璃體切除術
황반공%외상성%파리체절제술
Macular hole%traumatic%Vitrectomy
目的 观察玻璃体切除手术治疗外伤性黄斑孔的效果并探讨其优势.方法 回顾性观察手术治疗的外伤性黄斑孔共11例(11眼).排除视网膜脱离、脉络膜脱离、玻璃体积血、增生性玻璃体视网膜病变(PVR)、继发性黄斑孔及视神经萎缩.观察视力恢复及黄斑孔形态改变.结果 患者年龄16 ～56岁,平均(36.00±12.61)岁.外伤时间1～12个月,平均(4.59±4.18)月.术前最佳矫正视力(Sellen表)0.02～0.15,平均LogMAR 1.12±0.26,术后最佳矫正视力(Sellen表)0.02～0.8,平均LogMAR 0.80±0.45.术后视力较术前显著提高(t=3.761,P=O.004).术前黄斑孔最大直径336～1020 μm,平均(671.36±220.87)μm.10眼术后黄斑孔闭合.1眼黄斑孔直径1020 μm,未闭合.闭合时间5～30d,平均(17.42±1O.44)d.40岁以上者视力提高0～2行,平均(1±1)行,黄斑孔闭合时间20～30 d,平均(26.5+4.43)d；40岁以下者视力提高2～8行,平均(3.83±2.13)行,黄斑孔闭合时间5～28d,平均(14.8±8.47)d.结论 玻璃体切除联合内界膜剥除术能够在较短的时间内促进外伤性黄斑孔愈合,并显著改善视力预后.黄斑孔大者闭合几率低.黄斑孔大和年龄大者视功能预后差.
目的 觀察玻璃體切除手術治療外傷性黃斑孔的效果併探討其優勢.方法 迴顧性觀察手術治療的外傷性黃斑孔共11例(11眼).排除視網膜脫離、脈絡膜脫離、玻璃體積血、增生性玻璃體視網膜病變(PVR)、繼髮性黃斑孔及視神經萎縮.觀察視力恢複及黃斑孔形態改變.結果 患者年齡16 ～56歲,平均(36.00±12.61)歲.外傷時間1～12箇月,平均(4.59±4.18)月.術前最佳矯正視力(Sellen錶)0.02～0.15,平均LogMAR 1.12±0.26,術後最佳矯正視力(Sellen錶)0.02～0.8,平均LogMAR 0.80±0.45.術後視力較術前顯著提高(t=3.761,P=O.004).術前黃斑孔最大直徑336～1020 μm,平均(671.36±220.87)μm.10眼術後黃斑孔閉閤.1眼黃斑孔直徑1020 μm,未閉閤.閉閤時間5～30d,平均(17.42±1O.44)d.40歲以上者視力提高0～2行,平均(1±1)行,黃斑孔閉閤時間20～30 d,平均(26.5+4.43)d；40歲以下者視力提高2～8行,平均(3.83±2.13)行,黃斑孔閉閤時間5～28d,平均(14.8±8.47)d.結論 玻璃體切除聯閤內界膜剝除術能夠在較短的時間內促進外傷性黃斑孔愈閤,併顯著改善視力預後.黃斑孔大者閉閤幾率低.黃斑孔大和年齡大者視功能預後差.
목적 관찰파리체절제수술치료외상성황반공적효과병탐토기우세.방법 회고성관찰수술치료적외상성황반공공11례(11안).배제시망막탈리、맥락막탈리、파리체적혈、증생성파리체시망막병변(PVR)、계발성황반공급시신경위축.관찰시력회복급황반공형태개변.결과 환자년령16 ～56세,평균(36.00±12.61)세.외상시간1～12개월,평균(4.59±4.18)월.술전최가교정시력(Sellen표)0.02～0.15,평균LogMAR 1.12±0.26,술후최가교정시력(Sellen표)0.02～0.8,평균LogMAR 0.80±0.45.술후시력교술전현저제고(t=3.761,P=O.004).술전황반공최대직경336～1020 μm,평균(671.36±220.87)μm.10안술후황반공폐합.1안황반공직경1020 μm,미폐합.폐합시간5～30d,평균(17.42±1O.44)d.40세이상자시력제고0～2행,평균(1±1)행,황반공폐합시간20～30 d,평균(26.5+4.43)d；40세이하자시력제고2～8행,평균(3.83±2.13)행,황반공폐합시간5～28d,평균(14.8±8.47)d.결론 파리체절제연합내계막박제술능구재교단적시간내촉진외상성황반공유합,병현저개선시력예후.황반공대자폐합궤솔저.황반공대화년령대자시공능예후차.
Purpose To observe the clinical effect and the advantage of vitrectomy for traumatic macular hole(MH).Methods Retrospectively study a series of 11 patients(11 eyes)of traumatic macular hole.Vitrectomy,inner limiting membrane(ILM)peeling and long-term gas temponade were performed.The vision outcome was statistically analyzed.OCT was used to observe the change of macular hole.Results The age was 16-56 months(36 ± 12.61)yrs.The course from trauma to operation was 1-12(4.59 ± 4.18)months.The pre-operative best corrected visual acuity(BCVA)was O.02-0.15,main(LogMAR 1.12 ± 0.26)and the post-operative one was 0.02 ～ 0.8,main(LogMAR 0.80 ± O.45),which was statistically improved(t = 3.761,P = 0.004).The size of mactlar hole was 336-1020 μm,main(671.36 ± 220.87)μm.The hole was closed in 10 eyes and it was still exist in 1 eye in which the size was 1020 μm preoperatively.The time for macular hole close was 5-30 d,main(17.42 ± 10.44)d.The visual acuity was increased for 0-2 lines in the patients older than 40 years,mainly(1 ± 1)line,in which the hole closed in 20-30 days(mean 26.5 ± 4.43 d).It was 2-8 lines in patients of ＜40 years old,and the hole closed in 5-28 d(main 14.8 ± 8.47 d).Conclusion Vitrectomy combined with ILM peeling can successfully seal the traumatic macular hole in short time and significantly improve the vision outcome.The bigger hole is difticulte to close,and the vision prognosis was poor in big hole and old patient.
