中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2012年
12期
1088-1092
,共5页
贺峰%于伟泓%郑霖%董方田
賀峰%于偉泓%鄭霖%董方田
하봉%우위홍%정림%동방전
视网膜穿孔%玻璃体切除术%空气%体层摄影术,光学相干%光感受器
視網膜穿孔%玻璃體切除術%空氣%體層攝影術,光學相榦%光感受器
시망막천공%파리체절제술%공기%체층섭영술,광학상간%광감수기
Retinal perforations%Vitrectomy%Air%Tomography,optical coherence%Photoreceptors
目的 研究玻璃体切除手术联合空气填充治疗特发性黄斑裂孔的手术效果及其术后光感受器细胞层的改变.方法 回顾性病例系列研究.选择2009年1月至2011年5月行玻璃体切除手术联合空气填充治疗的45例(45只眼)特发性黄斑裂孔患者,采用频域相干光断层扫描测量患者黄斑裂孔直径及光感受器细胞层破坏直径.术前与术后最佳矫正视力和黄斑裂孔闭合率的相关性分析,采用Bivariate过程的Pearson相关分析法.结果 45例(45只眼)患者的术前最佳矫正视力为0.4至眼前手动,平均0.08;黄斑裂孔直径204～1616 μm,平均827.4 μm;光感受器细胞层破坏直径792～ 3444 μm,平均1988.9 μm.术后1个月,45例(45只眼)患者的黄斑裂孔闭合率为75.6％；最佳矫正视力为0.5至光感,平均0.13;光感受器细胞层破坏直径166～2553 μm,平均1285.1μm.患者术后视力较术前显著提高,光感受器细胞层破坏直径显著减小.术前的黄斑裂孔直径和术后的光感受器细胞层破坏直径与术后视力显著相关(r =0.526,0.628,P＜0.05).结论 玻璃体切除手术联合空气填充治疗特发性黄斑裂孔安全有效.术前的黄斑裂孔直径和术后的光感受器细胞层破坏直径是预测术后视力的最敏感指标之一.
目的 研究玻璃體切除手術聯閤空氣填充治療特髮性黃斑裂孔的手術效果及其術後光感受器細胞層的改變.方法 迴顧性病例繫列研究.選擇2009年1月至2011年5月行玻璃體切除手術聯閤空氣填充治療的45例(45隻眼)特髮性黃斑裂孔患者,採用頻域相榦光斷層掃描測量患者黃斑裂孔直徑及光感受器細胞層破壞直徑.術前與術後最佳矯正視力和黃斑裂孔閉閤率的相關性分析,採用Bivariate過程的Pearson相關分析法.結果 45例(45隻眼)患者的術前最佳矯正視力為0.4至眼前手動,平均0.08;黃斑裂孔直徑204～1616 μm,平均827.4 μm;光感受器細胞層破壞直徑792～ 3444 μm,平均1988.9 μm.術後1箇月,45例(45隻眼)患者的黃斑裂孔閉閤率為75.6％；最佳矯正視力為0.5至光感,平均0.13;光感受器細胞層破壞直徑166～2553 μm,平均1285.1μm.患者術後視力較術前顯著提高,光感受器細胞層破壞直徑顯著減小.術前的黃斑裂孔直徑和術後的光感受器細胞層破壞直徑與術後視力顯著相關(r =0.526,0.628,P＜0.05).結論 玻璃體切除手術聯閤空氣填充治療特髮性黃斑裂孔安全有效.術前的黃斑裂孔直徑和術後的光感受器細胞層破壞直徑是預測術後視力的最敏感指標之一.
목적 연구파리체절제수술연합공기전충치료특발성황반렬공적수술효과급기술후광감수기세포층적개변.방법 회고성병례계렬연구.선택2009년1월지2011년5월행파리체절제수술연합공기전충치료적45례(45지안)특발성황반렬공환자,채용빈역상간광단층소묘측량환자황반렬공직경급광감수기세포층파배직경.술전여술후최가교정시력화황반렬공폐합솔적상관성분석,채용Bivariate과정적Pearson상관분석법.결과 45례(45지안)환자적술전최가교정시력위0.4지안전수동,평균0.08;황반렬공직경204～1616 μm,평균827.4 μm;광감수기세포층파배직경792～ 3444 μm,평균1988.9 μm.술후1개월,45례(45지안)환자적황반렬공폐합솔위75.6％；최가교정시력위0.5지광감,평균0.13;광감수기세포층파배직경166～2553 μm,평균1285.1μm.환자술후시력교술전현저제고,광감수기세포층파배직경현저감소.술전적황반렬공직경화술후적광감수기세포층파배직경여술후시력현저상관(r =0.526,0.628,P＜0.05).결론 파리체절제수술연합공기전충치료특발성황반렬공안전유효.술전적황반렬공직경화술후적광감수기세포층파배직경시예측술후시력적최민감지표지일.
Objective To evaluate the tamponade effect of sterilized air in vitrectomy for idiopathic macular hole (IMH) as well as changes of photoreceptor layer after surgery.Methods Forty-five eyes of 45 consecutive cases underwent vitrectomy and air tamponade.Surgical outcomes were retrospectively analyzed,consisting of logarithm of the minimal angle of resolution (logMAR) and SD-OCT findings including the size of IMH and the photoreceptor layer defect.Results Preoperatively,mean BCVA was 0.08 (range,0.4 to HM),mean hole diameter was 827.4 μm (range,204 to 1616 μm),and mean diameter of photoreceptor layer defect was 1988.9 μm (range,792 to 3444 μm).The primary closure rate was 75.6％.One month after surgery,mean BCVA was 0.13 (range,0.5 to LP),and mean diameter of photoreceptor layer defect was 1285.1 μm (range,166 to 2553 μm),both presenting a significant decrease.Preoperative hole diameter and postoperative diameter of photoreceptor layer defect were statistically significantly correlated with postoperative BCVA (r=0.526,0.628 ; P＜0.05).Conclusions Vitrectomy plus air tamponade is safe and effective for the treatment of IMH,and the time for face-down positioning is obviously shortened.Preoperative hole diameter and postoperative diameter of photoreceptor layer defect are major predictive factors of visual acuity.
