中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
1期
51-54
,共4页
高度近视%视网膜劈裂%玻璃体切除术%光学相干断层扫描(OCT)
高度近視%視網膜劈裂%玻璃體切除術%光學相榦斷層掃描(OCT)
고도근시%시망막벽렬%파리체절제술%광학상간단층소묘(OCT)
High myopia%Retinoschisis%Vitrectomy%Optical coherence tomography (OCT)
目的 观察玻璃体切割手术伴与不伴内界膜剥离治疗高度近视黄斑部视网膜劈裂的疗效.方法 回顾分析29例29只眼高度近视黄斑视网膜劈裂患者的临床资料.根据治疗方法 分为2组.A组为单纯玻璃体切割手术,15例15只眼;B组为玻璃体切割手术加吲哚青绿染色内界膜剥离,14例14只眼.所有患者行惰性气体填充,手术后保持面朝下体位2周.术后观察患者的最佳矫正视力、黄斑部结构变化及术后并发症.术后平均随访时间9个月(6～14个月).结果 A组患者术后平均最佳矫正LogMAR视力0.51±0.19,与手术前比较,差异有统计学意义(t=3.901,P=0.001);B组患者手术后平均最佳矫正LngMAR视力0.50±0.27,与手术前比较,差异有统计学意义(t=3.130,P=0.004).两组间手术后视力差异无统计学意义(t=0.1160,P=0.909).A组15只眼中,10只眼手术后黄斑劈裂复位,占66.7%,改善5只眼,占33.3%,随访期内黄斑部视网膜劈裂复发2只眼;B组14只眼中12只眼首次手术视网膜复位,占85.7%,改善1只眼,占7.1%,术中黄斑裂孔形成1只眼.A、B两组手术视网膜复位率差异无统计学意义,(x2=1.435,P=0.238).结论 玻璃体切割联合惰性气体眼内填充治疗视网膜劈裂疗效确切,内界膜剥离对术后视力和视网膜劈裂的复位无显著影响.
目的 觀察玻璃體切割手術伴與不伴內界膜剝離治療高度近視黃斑部視網膜劈裂的療效.方法 迴顧分析29例29隻眼高度近視黃斑視網膜劈裂患者的臨床資料.根據治療方法 分為2組.A組為單純玻璃體切割手術,15例15隻眼;B組為玻璃體切割手術加吲哚青綠染色內界膜剝離,14例14隻眼.所有患者行惰性氣體填充,手術後保持麵朝下體位2週.術後觀察患者的最佳矯正視力、黃斑部結構變化及術後併髮癥.術後平均隨訪時間9箇月(6～14箇月).結果 A組患者術後平均最佳矯正LogMAR視力0.51±0.19,與手術前比較,差異有統計學意義(t=3.901,P=0.001);B組患者手術後平均最佳矯正LngMAR視力0.50±0.27,與手術前比較,差異有統計學意義(t=3.130,P=0.004).兩組間手術後視力差異無統計學意義(t=0.1160,P=0.909).A組15隻眼中,10隻眼手術後黃斑劈裂複位,佔66.7%,改善5隻眼,佔33.3%,隨訪期內黃斑部視網膜劈裂複髮2隻眼;B組14隻眼中12隻眼首次手術視網膜複位,佔85.7%,改善1隻眼,佔7.1%,術中黃斑裂孔形成1隻眼.A、B兩組手術視網膜複位率差異無統計學意義,(x2=1.435,P=0.238).結論 玻璃體切割聯閤惰性氣體眼內填充治療視網膜劈裂療效確切,內界膜剝離對術後視力和視網膜劈裂的複位無顯著影響.
목적 관찰파리체절할수술반여불반내계막박리치료고도근시황반부시망막벽렬적료효.방법 회고분석29례29지안고도근시황반시망막벽렬환자적림상자료.근거치료방법 분위2조.A조위단순파리체절할수술,15례15지안;B조위파리체절할수술가신타청록염색내계막박리,14례14지안.소유환자행타성기체전충,수술후보지면조하체위2주.술후관찰환자적최가교정시력、황반부결구변화급술후병발증.술후평균수방시간9개월(6～14개월).결과 A조환자술후평균최가교정LogMAR시력0.51±0.19,여수술전비교,차이유통계학의의(t=3.901,P=0.001);B조환자수술후평균최가교정LngMAR시력0.50±0.27,여수술전비교,차이유통계학의의(t=3.130,P=0.004).량조간수술후시력차이무통계학의의(t=0.1160,P=0.909).A조15지안중,10지안수술후황반벽렬복위,점66.7%,개선5지안,점33.3%,수방기내황반부시망막벽렬복발2지안;B조14지안중12지안수차수술시망막복위,점85.7%,개선1지안,점7.1%,술중황반렬공형성1지안.A、B량조수술시망막복위솔차이무통계학의의,(x2=1.435,P=0.238).결론 파리체절할연합타성기체안내전충치료시망막벽렬료효학절,내계막박리대술후시력화시망막벽렬적복위무현저영향.
Objective To evaluate the efficacy of vitreous surgery with/without internal limiting membrane (ILM) peeiing for highly myopic eyes with macular retinoschisis. Methods The clinical data of 29 high myopia patients (29 eyes) with macular retinoschisis were retrospectively analyzed. The patients were divided into two groups according to the treatment: 15 patients in group A had undergone conventional vitrectomy; 14 patients in group B had undergone vitrectomy and ILM peeling. All patients had been tamponaded by inert gas and kept in a face-down position for 2 weeks after the operation. The follow up period was 6-18 months (average 9 months). The best corrected visual acuity (BCVA), OCT had been followed up. Results Macular retinoschisis reattachment was found in 10 eyes (66.7%) in group A and 12 eyes in group B (85.7%).The difference was not significant (P >0.05). The postoperative BCVA increased significantly in both groups (P >0.05), the difference of vision improvement was not significant between the two groups (P >0.05). Conclusions Vitrectomy with/without ILM peeling is effective for treating macular retinoschisis in highly myopic eyes, ILM peeling can not significantly improve the postoperative visual acuity and retinoschisis renttachment.
