论著

内界膜翻瓣术联合空气填充治疗黄斑裂孔的效果评价

Efficacy of macular hole surgery with inverted internal limiting membrane flap technique and air tamponade

:323-330
 
目的:评估内界膜翻瓣术联合空气填充在黄斑裂孔手术应用中的有效性。方法:回顾性分析中山眼科中心2016—2019年入院,因黄斑裂孔行内界膜翻瓣术联合空气填充术治疗的患者71例71眼,术后俯卧位1~3 d且随访达6个月以上。通过OCT判断患者黄斑裂孔闭合率,比较患者术前及术后最佳矫正视力(best corrected visual acuity, BCVA),通过MAIA微视野计检查评估术前与术后黄斑平均光敏度、黄斑完整指数、固视稳定性P1及P2等指标。结果:在总的71只眼中,有91.5%达到了黄斑裂孔的完全闭合。患者术前及术后BCVA提升(P<0.001),黄斑平均光敏度增加(P<0.000 1)、黄斑完整指数降低(P<0.000 1)、固视稳定性P1(P<0.000 1)及P2(P<0.001)均提升。结论:内界膜翻瓣术联合空气填充是治疗黄斑裂孔有效的手术方式,空气填充可有效地辅助黄斑裂孔愈合,可作为优先考虑的术中填充物,减轻患者因长时间保持面向下体位带来的痛苦。微视野计参数可用作评估黄斑结构及功能恢复的良好指标。
Objective: To assess the efficacy of the inverted internal limiting membrane (ILM) flap technique with air tamponade for macular holes (MHs). Methods: A retrospective analysis was conducted on 71 patients (71 eyes) who underwent inverted ILM flap surgery combined with air tamponade for macular holes at Zhongshan Ophthalmic Center from 2016 to 2019. Patients were positioned face down for 1-3 days postoperatively and followed up for more than 6 months. OCT was used to determine the closure rate of macular holes, and the best corrected visual acuity (BCVA) before and after surgery was compared. The MAIA microperimeter was used to assess the average macular sensitivity, macular integrity index, and fixation stability P1 and P2 before and after surgery. Results: Of the total 71 eyes, 91.5% achieved complete MH closure. The best corrected visual acuity (BCVA) significantly improved before and after surgery (< 0.001), average macular sensitivity significantly increased (P < 0.000 1), macular integrity index significantly decreased (P < 0.000 1), and fixation stability P1 (P < 0.000 1) and P2 (P < 0.001) both significantly improved. Conclusions: Inverted ILM flap technique combined with air tamponade provides an effective approach for the management of MHs. The air tamponade should be considered as the preferred in MH surgeries, reducing the discomfort caused by prolonged face-down positioning. Parameters in microperimetry can serve as good indicators for assessing the recovery of macular structure and function.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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