黄斑裂孔玻璃体切割联合空气和SF6填充对比临床观察  

Clinical comparison investigation of vitrectomy combined with room air-filled and sulfur hexafluoride （SF6） about Idiopathic macular hole

作　　者：陶明[1] 张文芳[1] 李艳[1] 饶珊珊[1] 

机构地区：[1]兰州大学第二医院眼科,兰州730030

出　　处：《中国实用眼科杂志》2015年第7期785-788,共4页Chinese Journal of Practical Ophthalmology

摘　　要：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。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

关 键 词：特发性黄斑裂孔 空气 六氟化硫(SF6) 谱域OCT(SD-OCT) 

分 类 号：R774.5[医药卫生—眼科]