CAJ | 학술논문

目的分析高度近视眼黄斑裂孔性视网膜脱离的临床特征和手术疗效.方法采用系列病例研究,对近6年40例(40只眼)高度近视眼黄斑裂孔性视网膜脱离患者临床资料进行回顾性分析,所有患者均屈光不正均≥-6.00 D,不伴有周边视网膜裂孔.结果 40例(40只眼)中,男8例,女32例.年龄33～76岁,平均59.3岁.平均随诊时间12.3个月.视网膜最终复位36只眼(90.0%).术后视力提高30只眼(75.0%),保持稳定5只眼(12.5%),下降5只眼.术后视力较术前视力提高(P=0.000).预示术后视力差的因素:伴有后巩膜葡萄肿(P=0.023),伴有视网膜色素上皮萎缩(P=0.001).术中剥除内界膜17只眼,保留内界膜23只眼,剥除内界膜组视网膜复位率(94.1%),保留内界膜组视网膜复位率(78.3%),两组术后视力提高差异无统计学意义(P=0.240).结论现代玻璃体视网膜手术治疗高度近视眼黄斑裂孔性视网膜脱离可以使视网膜脱离绝大多数复位,手术后大多数眼能改善或保持视力.
목적 분석고도근시안황반렬공성시망막탈리적림상특정화수술료효.방법 채용계렬병례연구,대근6년40례(40지안)고도근시안황반렬공성시망막탈리환자림상자료진행회고성분석,소유환자균굴광불정균≥-6.00 D,불반유주변시망막렬공.결과 40례(40지안)중,남8례,녀32례.년령33～76세,평균59.3세.평균수진시간12.3개월.시망막최종복위36지안(90.0%).술후시력제고30지안(75.0%),보지은정5지안(12.5%),하강5지안.술후시력교술전시력제고(P=0.000).예시술후시력차적인소:반유후공막포도종(P=0.023),반유시망막색소상피위축(P=0.001).술중박제내계막17지안,보류내계막23지안,박제내계막조시망막복위솔(94.1%),보류내계막조시망막복위솔(78.3%),량조술후시력제고차이무통계학의의(P=0.240).결론 현대파리체시망막수술치료고도근시안황반렬공성시망막탈리가이사시망막탈리절대다수복위,수술후대다수안능개선혹보지시력.
Objective To investigate the clinical features and to evaluate the visual and anatomical outcomes in a series of vitreous surgeries for retinal detachment associated with macular hole in high myopic eyes. Methods The clinical data of 40 patients (40 eyes) , 8 males and 32 females, aged 33 -76, who received vitreous surgery for retinal detachment due to macular hole in high myopic eyes with the previous refractive error≥-6.00 D without peripheral retinal hole from January 2001 to January 2007 were retrospectively analyzed. The patients were followed up for 12.3 months. Results Overall anatomical success was achieved in 36 eyes (90.0%). 30 eyes ( 75.0% ) had visual improvement. Vision remained unchanged in 5 eyes (12.5%) and decreased in 5 eyes. Postoperative visual acuity improved much more than preoperative visual acuity (P=0.000). Predictors of poor visual outcome were: posterior staphyloma (P=0.023) and atrophy of retinal pigment epithelium (P=0.001 ). Internal limiting membrane (ILM)peeling (ILM-peeled group) was performed on 17 eyes, and the ILM was not removed on 23 eyes (ILM-preserved group). The anatomic reattachment rate after the initial surgery in the ILM-peeled group was 94.1%. and in the ILM-preserved group was 78.3%. There was not significant difference in the improvement of postoperative visual acuity between these two groups (P = 0.240). Conclusion Vitreous surgery achieves retinal reattachment and improves or preserves the visual acuity in the eyes with retinal detachment due to macular hole in high myopic eyes.