中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2013年
12期
1599-1601
,共3页
特发性黄斑裂孔%23G微创玻璃体切割%视网膜内界膜
特髮性黃斑裂孔%23G微創玻璃體切割%視網膜內界膜
특발성황반렬공%23G미창파리체절할%시망막내계막
3G transconjunctival sutureless vitrectomy%Idiopathic macular hole%Internal retinal membrane
目的 观察23G微创玻璃体切割术(23GTSV)联合视网膜内界膜剥除(ILMP)治疗特发性黄斑裂孔(IMH)的临床疗效.方法 回顾分析2010年2月至2012年12月在大连大学附属中山医院眼科经23G TSV联合ILMP治疗并随诊1年以上的特发性黄斑裂孔患者36例36只眼的临床资料.所有患者手术前后均行最佳矫正视力(BCVA)、眼压、晶状体状态、间接检眼镜、裂隙灯显微镜+90 D前置镜、OCT-3000(德国Zeiss公司)以及FFA检查.回顾分析手术前后视力,0CT检查结果以及手术并发症的发生情况.结果 视力提高30只眼,占83.33％;视力不变4只眼,占11.11％;视力减退2只眼,占5.55％.术后12个月视力为0.10～0.80,平均(0.40±0.10);与术前视力0.02～0.20,平均0.10±0.04比较,差异有统计学意义(f=4.50,P＜0.01).术后12个月时黄斑平均厚度为(267±120)μm,和手术前黄斑厚度(491±104) μm比较,差异有统计学意义(f=5.66,P＜0.01); 36例黄斑裂孔均闭合,其中1只眼(占2.78％)术后1个月时黄斑裂孔复发,再次行气液交换C3F8注入,待1个月后复查,黄斑裂孔闭合.术中视网膜裂孔表面出现1～3个点状自限性出血者5只眼.术后一过性眼压升高5只眼,一过性低眼压7只眼.结论 经玻璃体切割手术剥离黄斑前膜可以减轻黄斑水肿,提高视力,是治疗黄斑裂孔的有效方法.
目的 觀察23G微創玻璃體切割術(23GTSV)聯閤視網膜內界膜剝除(ILMP)治療特髮性黃斑裂孔(IMH)的臨床療效.方法 迴顧分析2010年2月至2012年12月在大連大學附屬中山醫院眼科經23G TSV聯閤ILMP治療併隨診1年以上的特髮性黃斑裂孔患者36例36隻眼的臨床資料.所有患者手術前後均行最佳矯正視力(BCVA)、眼壓、晶狀體狀態、間接檢眼鏡、裂隙燈顯微鏡+90 D前置鏡、OCT-3000(德國Zeiss公司)以及FFA檢查.迴顧分析手術前後視力,0CT檢查結果以及手術併髮癥的髮生情況.結果 視力提高30隻眼,佔83.33％;視力不變4隻眼,佔11.11％;視力減退2隻眼,佔5.55％.術後12箇月視力為0.10～0.80,平均(0.40±0.10);與術前視力0.02～0.20,平均0.10±0.04比較,差異有統計學意義(f=4.50,P＜0.01).術後12箇月時黃斑平均厚度為(267±120)μm,和手術前黃斑厚度(491±104) μm比較,差異有統計學意義(f=5.66,P＜0.01); 36例黃斑裂孔均閉閤,其中1隻眼(佔2.78％)術後1箇月時黃斑裂孔複髮,再次行氣液交換C3F8註入,待1箇月後複查,黃斑裂孔閉閤.術中視網膜裂孔錶麵齣現1～3箇點狀自限性齣血者5隻眼.術後一過性眼壓升高5隻眼,一過性低眼壓7隻眼.結論 經玻璃體切割手術剝離黃斑前膜可以減輕黃斑水腫,提高視力,是治療黃斑裂孔的有效方法.
목적 관찰23G미창파리체절할술(23GTSV)연합시망막내계막박제(ILMP)치료특발성황반렬공(IMH)적림상료효.방법 회고분석2010년2월지2012년12월재대련대학부속중산의원안과경23G TSV연합ILMP치료병수진1년이상적특발성황반렬공환자36례36지안적림상자료.소유환자수술전후균행최가교정시력(BCVA)、안압、정상체상태、간접검안경、렬극등현미경+90 D전치경、OCT-3000(덕국Zeiss공사)이급FFA검사.회고분석수술전후시력,0CT검사결과이급수술병발증적발생정황.결과 시력제고30지안,점83.33％;시력불변4지안,점11.11％;시력감퇴2지안,점5.55％.술후12개월시력위0.10～0.80,평균(0.40±0.10);여술전시력0.02～0.20,평균0.10±0.04비교,차이유통계학의의(f=4.50,P＜0.01).술후12개월시황반평균후도위(267±120)μm,화수술전황반후도(491±104) μm비교,차이유통계학의의(f=5.66,P＜0.01); 36례황반렬공균폐합,기중1지안(점2.78％)술후1개월시황반렬공복발,재차행기액교환C3F8주입,대1개월후복사,황반렬공폐합.술중시망막렬공표면출현1～3개점상자한성출혈자5지안.술후일과성안압승고5지안,일과성저안압7지안.결론 경파리체절할수술박리황반전막가이감경황반수종,제고시력,시치료황반렬공적유효방법.
Objective To evaluate the long-term result of 23G transconjunctival sutureless vitrectomy (TSV) with internal limiting membrane peeling (ILMP) for idiopathic macular hole (IMH).Methods In a retrospective consecutive series,thirty-six eyes of 36 patients with IMH who underwent 23G TSV and ILMP which had more than 1 year follow up were included.All the patients were examined by BCVA,fundus color photography,fluorescein fundus angiography (FFA),optical coherence tomography (OCT) before and after treatment.BCVA was adopted 5 points record; FFA and OCT were underway as common way.Results Visual improvement was achieved in 30 eyes (83.33％),meanwhile,4 eyes (11.11％) were stable and 2 eyes (5.55％) were worse.After 12 months follow up the mean BCVA was increased from (0.10±0.04) to (0.40±0.10) postoperatively,the difference was statistically significant (t =4.50,P ＜0.01).Mean macular thickness decreased from (491±104)μm to (267±120)μm postoperatively,the difference was statistically significant (t =5.66,P ＜0.01).The IMH of 36 eyes all had been cured,one eye had undergone the second operation,5 eyes had retinal hemorrhage intraoperatively; 5 eyes had transient higher intraocular pressure,7 eyes had transient lower intraocular pressure.Conclusions 3G TSV and internal limiting membrane peeling is a effective method in treating IMH.It can relieve macular edema and improve visual acuity.
