玻璃体切除术联合不同气体充填治疗特发性黄斑裂孔  

Vitrectomy combined with different gas tamponade in treatment of idiopathic macular hole

作　　者：刘永坚[1] 陈真[1] 李勇[1] 

机构地区：[1]广东省增城市新塘医院湛兆霖眼科中心,广东增城511340

出　　处：《中国医药科学》2014年第17期202-203,207,共3页China Medicine And Pharmacy

摘　　要：目的：探讨玻璃体切除术中是否填充惰性气体对治疗特发性黄斑裂孔疗效影响。方法回顾2008年6月～2011年6月确诊的特发性黄斑裂孔2期或以上患者共66例（70只眼），随机分为C3F8充填组（治疗组）35只眼，及空气充填组（对照组）35只眼，两组分别行玻璃体切除联合内界膜剥除后行气液交换术，手术医生均为同一人，术后随访1～6个月。对比两组患者手术前后的矫正视力改变情况；前置镜下观察对比两组裂孔闭合情况；用蔡司Cirrus HD-OCT观察对比两组手术前后黄斑裂孔的OCT图像改变情况。结果视力：两组患者术后视力均有提高，两组的术后6个月矫正视力比较，t=2.1290，P＜0.05，两组视力存在统计学差异。治疗组各个分期患者闭合率均为100%，而对照组2期闭合9例（90％），3期17例（85％），4期3例（60％）。结论 C3F8充填组在术后矫正视力以及裂孔闭合率均比对照组要好，玻璃体切除联合内界膜剥离及C3F8填充治疗特发性黄斑裂孔，手术效果可靠，裂孔闭合率高。Objective To evaluate the clinical effect of vitrectomy on idiopathic macular hole with noble gas or not.Methods A total of 70 eyes of 66 patients diagnosed with idiopathic macular hole were divided into 2 groups. Patients were treated with vitrectomy surgery combined with ERM peeling, A/F exchange and gass tamponade. Surgery of A group was tamponaded with noble gas and B group was tamponaded with air. ALL of the operations were treated by the same surgeons. After the treatments ,we contrasted the vision ,macular hole occlusion,and OCT images of the two patient groups for 1-6 months.Results After operation, vision of the two groups was both improved but T test results between the two groups statistically significant difference at 6 months （t=2.1290,P〈0.05）. 100% anatomical closure was observed in A group. In B group, 90% anatomical closure was observed on stage 2 ,85% on stage 3,and 60% on stage 4.Conclusion Observed by this study, vitrectomy combined with noble gass tamponade is an better and ideal method to treat idiopathic macular hole contrasted with air tamponade.

关 键 词：特发性黄斑裂孔 IMH C3F8 惰性气体 玻璃体切除术 

分 类 号：R779.6[医药卫生—眼科]