CAJ | 학술논문

目的比较极高度近视黄斑裂孔性视网膜脱离(MHRD)手术后C3F8与硅油填充的疗效.方法眼轴长度≥29 mm,视网膜色素上皮(RPE)及脉络膜明显萎缩及存在明显巩膜后葡萄肿的极高度近视MHRD住院患者32例32只眼纳入研究.采用随机数字表法将患眼随机分为C3F8组、硅油组,分别为15、17只眼.所有患者均行玻璃体切割手术,手术完毕时C3F8组患眼眼内填充C3F8,硅油组患眼眼内填充硅油.手术后发生视网膜再脱离者行再次手术.C3F8组、硅油组患者性别(P=1.000)、年龄(t=0.444,P=0.660)、最佳矫正视力(t=0.084,P=0.934)、屈光度(t=0.449,P=0.978)、晶状体状态(P=1.000)、症状出现时间(t=0.375,P=0.710)及视网膜脱离程度(x2=0.014,P=0.907)比较,差异均无统计学意义.手术后1周及1、3、6、12个月,观察患者视网膜复位、黄斑裂孔闭合及并发症的发生情况.对比分析两组患者视网膜复位率、黄斑裂孔闭合率及视力情况.结果第1次手术后,C3F8组、硅油组视网膜复位率分别为60.00％、82.35％,黄斑裂孔闭合率分别为13.33％、29.41％.两组第1次手术后视网膜复位率、黄斑裂孔闭合率比较,差异均无统计学意义(P=0.243、0.402).第2次手术后,C3F8组、硅油组视网膜复位率分别为86.67％、94.12％,黄斑裂孔闭合率分别为20.00％、29.41％.两组第2次手术后视网膜复位率、黄斑裂孔闭合率比较,差异均无统计学意义(P=0.589、0.691).手术后12个月,C3F8组视力提高5只眼,视力不变7只眼,视力下降3只眼；硅油组视力提高7只眼,视力不变8只眼,视力下降2只眼.两组视力情况比较,差异无统计学意义(x2 =0.209,P=0.647).结论极高度近视MHRD患眼手术后硅油填充较C3F8填充视网膜复位率及黄斑裂孔闭合率高,但差异无统计学意义.
목적 비교겁고도근시황반렬공성시망막탈리(MHRD)수술후C3F8여규유전충적료효.방법 안축장도≥29 mm,시망막색소상피(RPE)급맥락막명현위축급존재명현공막후포도종적겁고도근시MHRD주원환자32례32지안납입연구.채용수궤수자표법장환안수궤분위C3F8조、규유조,분별위15、17지안.소유환자균행파리체절할수술,수술완필시C3F8조환안안내전충C3F8,규유조환안안내전충규유.수술후발생시망막재탈리자행재차수술.C3F8조、규유조환자성별(P=1.000)、년령(t=0.444,P=0.660)、최가교정시력(t=0.084,P=0.934)、굴광도(t=0.449,P=0.978)、정상체상태(P=1.000)、증상출현시간(t=0.375,P=0.710)급시망막탈리정도(x2=0.014,P=0.907)비교,차이균무통계학의의.수술후1주급1、3、6、12개월,관찰환자시망막복위、황반렬공폐합급병발증적발생정황.대비분석량조환자시망막복위솔、황반렬공폐합솔급시력정황.결과 제1차수술후,C3F8조、규유조시망막복위솔분별위60.00％、82.35％,황반렬공폐합솔분별위13.33％、29.41％.량조제1차수술후시망막복위솔、황반렬공폐합솔비교,차이균무통계학의의(P=0.243、0.402).제2차수술후,C3F8조、규유조시망막복위솔분별위86.67％、94.12％,황반렬공폐합솔분별위20.00％、29.41％.량조제2차수술후시망막복위솔、황반렬공폐합솔비교,차이균무통계학의의(P=0.589、0.691).수술후12개월,C3F8조시력제고5지안,시력불변7지안,시력하강3지안；규유조시력제고7지안,시력불변8지안,시력하강2지안.량조시력정황비교,차이무통계학의의(x2 =0.209,P=0.647).결론 겁고도근시MHRD환안수술후규유전충교C3F8전충시망막복위솔급황반렬공폐합솔고,단차이무통계학의의.
Objective To compare the outcome of C3F8 versus silicone oil intraocular tamponade after pars plana vitrectomy (PPV) for the treatment of severe highly myopic macular hole retinal detachment (MHRD).Methods Thirty-two highly myopic MHRD patients (32 eyes) with extreme long axial lengths (≥ 29.0 mm)," severe" retina pigment epithelium (RPE) and chorioretinal atrophy,and posterior staphyloma who underwent PPV,were enrolled in this study.The patients were divided into two groups according to different intraocular tamponade agents:C3F8 (group A,15 eyes) and silicone oil (group B,17eyes).The patients with retinal re-detachment after surgery received PPV again.The differences of sex (P =1.000),age (t=0.444,P=0.660),best-corrected visual acuity (t=0.084,P=0.934),diopter (t=0.449,P=0.978),lens state (P=1.000),time of the symptoms (t=0.375,P=0.710) and degree of retinal detachment (x2 =0.014,P=0.907) between group A and B were not statistically significant.The anatomic reattachment of the retina,macular hole closure,and vision acuity were observed at one week,one,three,six and 12 months after surgery.Results The rates of retinal reattachment and macular hole closure were 60.00％ and 13.33 ％ in group A,82.35％ and 29.41％ in group B in the first time of surgery.There was no difference in rates of retinal reattachment and macular hole closure between two groups (P=0.243,0.402).The rates of retinal reattachment and macular hole closure were 86.67％ and 20.00％ in group A,94.12％ and 29.41％ in group B in the second time of surgery.There was no difference in rates of retinal reattachment and macular hole closure between two groups (P=0.589,0.691).Twelve months after surgery,the vision acuity improved in five eyes,unchanged in seven eyes,and decreased in three eyes in group A; the vision acuity improved in seven eyes,unchanged in eight eyes,and decreased in two eyes in group B.The differences of vision result was not statistically significant between two groups (x2 =0.209,P=0.647).Conclusion The rates of retinal reattachment and macular hole closure with silicone oil tamponade was higher than that with C3F8 tamponade in eyes with severe highly myopic MHRD,but the differences are not statistically significant.