玻璃体切割联合黄斑加固术治疗高度近视合并黄斑裂孔性视网膜脱离  

Vitrectomy combined with macular buckling for high myopia and macular hole retinal detachment

作　　者：万文萃[1] 刘宇莹[1] 杨果果 庞雪娜 尹向可 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

出　　处：《眼科新进展》2015年第8期748-750,共3页Recent Advances in Ophthalmology

基　　金：河南省科技攻关项目资助(编号:122102310227)~~

摘　　要：目的观察玻璃体切割联合黄斑加固术治疗高度近视合并黄斑裂孔性视网膜脱离患者术后视网膜的解剖复位率和黄斑裂孔的闭合率。方法收集自2012年1月至2014年12月在我院手术的高度近视合并黄斑裂孔性视网膜脱离的患者64例(64眼),根据手术方式不同分成2组:一组行单纯玻璃体切割术为单纯玻切组,另一组行玻璃体切割联合黄斑加固术为联合手术组,观察两组视力及视网膜解剖复位率和黄斑裂孔闭合率。结果 64例64眼中,单纯玻切组36例,术前视力平均为0.90 log MAR,术后平均为0.41 log MAR;联合手术组28例,术前视力平均为0.89 log MAR,术后平均为0.62 log MAR;两组术前视力差异无统计学意义,术后差异有统计学意义(P=0.04)。两组患者术后视网膜复位均率为100%;联合手术组的黄斑裂孔闭合率较高,为92.9%,单纯玻切组为41.7%,两组比较差异有统计学意义(P=0.02)。结论在高度近视合并黄斑裂孔性视网膜脱离的患者中,联合行黄斑加固术较单纯玻璃体切割术患者的黄斑裂孔闭合率要高。Objective To observe the retinal anatomical reset rate and macular hole closure rate of vitrectomy combined with macular buckling and silicone oil tam- ponade for high myopia and macuiar hole retinal detachment. Methods A retrospec- tive consecutive interventional study from medical records on 54 patients （64 eyes） who underwent vitrectomy with or without macular buckling in the treatment of retinal detachment associated with macular hole from January 2012 to December 2014 were performed, the patients were divided into two groups：Simple vitrectomy group （35 ca- ses） and combined surgery group （vitrectomy combined with macular buckling,28 cases）, the postoperative visual acuity, retinal anatomical reset rate and macular hole clo- sure rate were observed. Results The preoperative visual acuity in simple vitrectomy group and combined surgery group were 0.90 logMAR and 0.89 logMAR, there was no statistical difference （ P 〉 0.05 ） ; The postoperative visual acuity in simple vitrectomy group and combined surgery group were 0.41 logMAR and 0.52 logMAR,there was statistical difference （P = 0.04）. The postoperative retinal anatomical reset rate in the two groups were all 100% , and the postoperative macuiar hole closure rate in simple vitrectomy group and combined surgery group were 41.7% and 92.9% , respectively, there was statistical difference （P = 0.02）. Conclusion For patients with high myopia and macuiar hole retinal detachment, the postoperative macular hole closure rate of com- bined surgery is higher than that of simple vitrectomy.

关 键 词：黄斑加固术 高度近视 黄斑裂孔 视网膜脱离 

分 类 号：R774.12[医药卫生—眼科]