中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
Chinese Journal of Practical Ophthalmology
2015年
7期
785-788
,共4页
陶明%张文芳%李艳%饶珊珊
陶明%張文芳%李豔%饒珊珊
도명%장문방%리염%요산산
特发性黄斑裂孔%空气%六氟化硫(SF6)%谱域OCT(SD-OCT)
特髮性黃斑裂孔%空氣%六氟化硫(SF6)%譜域OCT(SD-OCT)
특발성황반렬공%공기%륙불화류(SF6)%보역OCT(SD-OCT)
Idiopathic macular hole%Air%Sulfur hexafluoride (SF6)%Spectral domain optical coherence tomography (SD-OCT)
目的 观察特发性黄斑裂孔玻璃体切割术分别填充空气和SF6在裂孔闭合和视功能变化的异同,确定玻璃体术后空气填充是否为特发性黄斑裂孔有效方式.方法 采用回顾性分析研究.选择2012年1月至2014年12月在兰州大学第二医院眼科中心收治的特发性黄斑裂孔孔径≤600 μm的患者,第一组:31例行23G玻璃体切割术后填充空气,第二组选择31例行23G玻璃体切割术后填充20％ SF6,观察两组最佳矫正视力(BCVA)、裂孔闭合、IS/OS破坏直径、手术前后视物变形程度、手术并发症,探讨玻璃体切割术后空气填充的临床意义及应用价值.结果 (1)孔径≤250μm的闭合率:两组均是100％;孔径250～400 μm的闭合率:空气组为88.9％,SF6组为91.7％;孔径400～600 μm的闭合率:空气组为93.3％,SF6组为92.9％,两组闭合率的差异无统计学意义(P＞0.05).(2)空气组最佳矫正视力在基线和术后1、3个月是0.12±0.08,0.28±0.15和0.27±0.18,SF6组是0.11±0.07,0.27±0.23和0.27±0.20,两组最佳矫正视力在各时间段无统计学意义(P ＞0.05).(3)术后3个月,两组间IS/OS破坏直径差异无统计学意义(P=0.23).(4)两组俯卧位时间上差异有统计学意义(P＜0.01).(5)两组患者视物变形有不同程度改善,两组间差异无统计学意义(P ＞0.05).(6)在术后3个月的观察期内空气组3例、SF6组4例发生少量玻璃体出血,均在1个月内完全吸收.SF6组l例发生眼内炎,玻璃体腔注药后治愈.结论 孔径≤600 μm的特发性黄斑孔,与填充SF6相比,空气填充能达到同样的裂孔闭合、视功能恢复、俯卧位的时间更短并且无严重并发症发生,空气填充是值得推荐的手术方式.
目的 觀察特髮性黃斑裂孔玻璃體切割術分彆填充空氣和SF6在裂孔閉閤和視功能變化的異同,確定玻璃體術後空氣填充是否為特髮性黃斑裂孔有效方式.方法 採用迴顧性分析研究.選擇2012年1月至2014年12月在蘭州大學第二醫院眼科中心收治的特髮性黃斑裂孔孔徑≤600 μm的患者,第一組:31例行23G玻璃體切割術後填充空氣,第二組選擇31例行23G玻璃體切割術後填充20％ SF6,觀察兩組最佳矯正視力(BCVA)、裂孔閉閤、IS/OS破壞直徑、手術前後視物變形程度、手術併髮癥,探討玻璃體切割術後空氣填充的臨床意義及應用價值.結果 (1)孔徑≤250μm的閉閤率:兩組均是100％;孔徑250～400 μm的閉閤率:空氣組為88.9％,SF6組為91.7％;孔徑400～600 μm的閉閤率:空氣組為93.3％,SF6組為92.9％,兩組閉閤率的差異無統計學意義(P＞0.05).(2)空氣組最佳矯正視力在基線和術後1、3箇月是0.12±0.08,0.28±0.15和0.27±0.18,SF6組是0.11±0.07,0.27±0.23和0.27±0.20,兩組最佳矯正視力在各時間段無統計學意義(P ＞0.05).(3)術後3箇月,兩組間IS/OS破壞直徑差異無統計學意義(P=0.23).(4)兩組俯臥位時間上差異有統計學意義(P＜0.01).(5)兩組患者視物變形有不同程度改善,兩組間差異無統計學意義(P ＞0.05).(6)在術後3箇月的觀察期內空氣組3例、SF6組4例髮生少量玻璃體齣血,均在1箇月內完全吸收.SF6組l例髮生眼內炎,玻璃體腔註藥後治愈.結論 孔徑≤600 μm的特髮性黃斑孔,與填充SF6相比,空氣填充能達到同樣的裂孔閉閤、視功能恢複、俯臥位的時間更短併且無嚴重併髮癥髮生,空氣填充是值得推薦的手術方式.
목적 관찰특발성황반렬공파리체절할술분별전충공기화SF6재렬공폐합화시공능변화적이동,학정파리체술후공기전충시부위특발성황반렬공유효방식.방법 채용회고성분석연구.선택2012년1월지2014년12월재란주대학제이의원안과중심수치적특발성황반렬공공경≤600 μm적환자,제일조:31례행23G파리체절할술후전충공기,제이조선택31례행23G파리체절할술후전충20％ SF6,관찰량조최가교정시력(BCVA)、렬공폐합、IS/OS파배직경、수술전후시물변형정도、수술병발증,탐토파리체절할술후공기전충적림상의의급응용개치.결과 (1)공경≤250μm적폐합솔:량조균시100％;공경250～400 μm적폐합솔:공기조위88.9％,SF6조위91.7％;공경400～600 μm적폐합솔:공기조위93.3％,SF6조위92.9％,량조폐합솔적차이무통계학의의(P＞0.05).(2)공기조최가교정시력재기선화술후1、3개월시0.12±0.08,0.28±0.15화0.27±0.18,SF6조시0.11±0.07,0.27±0.23화0.27±0.20,량조최가교정시력재각시간단무통계학의의(P ＞0.05).(3)술후3개월,량조간IS/OS파배직경차이무통계학의의(P=0.23).(4)량조부와위시간상차이유통계학의의(P＜0.01).(5)량조환자시물변형유불동정도개선,량조간차이무통계학의의(P ＞0.05).(6)재술후3개월적관찰기내공기조3례、SF6조4례발생소량파리체출혈,균재1개월내완전흡수.SF6조l례발생안내염,파리체강주약후치유.결론 공경≤600 μm적특발성황반공,여전충SF6상비,공기전충능체도동양적렬공폐합、시공능회복、부와위적시간경단병차무엄중병발증발생,공기전충시치득추천적수술방식.
Objective To survey the closure rate, functional and morphological recovery after surgery with room air-filled and SF6 in idiopathic macular hole in order to obtain whether air tamponade is the recommended way after vitrectomy in idiopathic macular hole.Methods The first group:a total of 31 eyes of 31 patients with consecutive idiopathic macular hole,who undergone transcon junctival 23-gauge pars plana vitrectomy with air-filled were retrospectively studied.The second group:a total of 31 eyes of 31 patients with consecutive idiopathic macular hole with the first group match,who undergone the same surgery with 20％ SF6-filled.Surgical outcomes were analyzed, regarding best-corrected visual acuity (BCVA),hole closure rate, damage diameter of IS/OS with spectral domain optical coherence tomography (SD-OCT),the degree of visual distortion efore and after surgery, surgical complications to discuss clinical significance and value about the patients after air amponade.Results The closure rate was 100％ for both groups of holes diameter ≤250μ m.The closure rate of the air group was 88.9％ from 250 to 400μ m, the closure rate of the SF6 group was 91.7％ in the sameiameter;the closure rate of the air group was 93.3％ from 400 to 600μm, the losure rate of the SF6 group was 92.9％ in the same diameter.The differences of two groups were not statistically significant.Mean BCVA at baseline, month 1 and month 3 was 0.12±0.08, 0.28±0.15 and 0.27±0.18 in air group;Mean BCVA at baseline, month l and month 3 was 0.11±0.07, 0.27±0.23 and 0.27±0.20 in SF6 group.There were no significant differences in BCVA at anytime points between the 2 groups.Damage diameter of IS/OS was 1245.3±396.5μm after surgery 3 months in air group.The SF6 group was 1316.3±336.2μm after surgery 3 months.The differences were not statistically significant after surgery 3 months between the 2 groups (P =0.23).The mean prone osturing period were significant differences between the 2 groups (P ＜0.0001).The degree of visual distortion had improvements between the 2 groups.The differences were not statistically significant etween the 2 groups.There was a small amount of vitreous hemorrhage in 2 groups.These cases were completely absorbed in one month.Others were no any serious surgical complications.Conclusions This study shows that room air tamponade can obtain good closure rate, recovery of visual function, a short time in the prone position and no any serious surgical complications for idiopathic macular hole compared to SF6.Air tamponade is the recommended way after vitrectomy in idiopathic macular hole.
