玻璃体切割联合内界膜剥离术治疗外伤性黄斑裂孔  

Traumatic macular hole treated by inner limiting membrane peeling with vitreous cutting operation

作　　者：万文萃[1] 张向东[2] 李晓丹[1] 张楠楠[1] 金学民[1] 

机构地区：[1]郑州大学第一附属医院眼科,河南省郑州市450052 [2]新乡医学院第三附属医院眼科,河南省新乡市453003

出　　处：《眼科新进展》2013年第10期949-951,共3页Recent Advances in Ophthalmology

基　　金：河南省科技攻关项目基金资助(编号:122102310227)~~

摘　　要：目的观察玻璃体切割联合内界膜剥离术治疗外伤性黄斑裂孔的手术效果。方法选择2010年1月至2012年9月在我院经手术治疗的外伤性全层黄斑裂孔患者24例（24眼），所有患者均采用玻璃体切割联合内界膜剥离术治疗，术中采用C/3F/8气体填充玻璃体，嘱患者俯卧位7～14d，术后随访6～14个月，OCT观察黄斑裂孔情况，并记录患者最佳矫正视力及术中、术后并发症情况。结果所有患眼手术均顺利完成，未见严重术中、术后并发症发生。至随访期末，24眼中视力提高2行以上者17眼（70．83％）。术后1个月内22眼（91．67％）黄斑裂孔经0CT证实完全闭合，且随访期内未见复发；另2眼黄斑裂孔术后6个月始终未闭合，其中1眼为术前合并有玻璃体积血及黄斑裂孔周围脉络膜挫伤者，1眼为爆炸伤后2a才要求手术者。结论玻璃体切割联合内界膜剥离术能够有效治疗外伤性黄斑裂孔并提高患者的最佳矫正视力。Objective To observe the effects of inner limiting membrane peelingwith vitreous cutting operation on traumatic macular hole. Methods Twenty-four pa- tients （24 eyes） with traumatic macular hole treated by surgery in our hospital between January ,2010 and September,2012 were selected. All the patients treated with inner lim- iting membrane peeling with vitreous cutting operation and vitreous was filled with C3F8. Patients were asked to sleep in prone position for 7 - 14 days. Macular hole was observed by OCT in the 6 - 14 months＇ follow up. The best corrected visual acuity and complications during and after operation were recorded. Results All the surgerys were successful and no serious complications were found during and after operation. At the end of the follow up ,vision of 17 eyes in 24 eyes improved 2 lines （70.83%）. OCT confirmed that macular holes in 22 eyes （91. 67% ） were completely closed in one month postoperation,and relapse didn＇ t appear in the follow-up. Macular holes in 2 eyes still opened in post-operative 6 months. Conclusion Inner limiting membrane peeling with vitreous cutting operation may effectively treat traumatic macular hole and improve the best corrected visual acuity.

关 键 词：黄斑裂孔 玻璃体切割 内界膜剥离 

分 类 号：R774.5[医药卫生—眼科]