23G微创玻璃体手术治疗黄斑前膜临床疗效及预后分析  

Clinical outcome and prognostic analysis of macular epiretinal membrane removal by 23-gauge vitrectomy

作　　者：孙涛[1] 张平[1] 李媛[1] 姜允彬 孙晓东[1] 王泓[1] 

机构地区：[1]上海交通大学附属第一人民医院眼科,200080

出　　处：《中国实用眼科杂志》2016年第5期466-469,共4页Chinese Journal of Practical Ophthalmology

基　　金：国家自然科学基金青年项目，上海市卫生局青年科研项目(20114Y054)National Natural Science Foundation for Young Scholars of China，Science Foundation for Young Scholars of Shanghai Health Bureau

摘　　要：目的 探讨23G微创玻璃体手术治疗黄斑前膜的临床应用价值和影响术后视力的相关因素.方法 临床病例系列研究.对2010年6月至2013年12月在上海市第一人民医院眼科就诊的黄斑前膜患者30只眼行23G微创玻璃体手术前、术后1个月、术后3个月的临床资料.所有患者均剥除黄斑前膜和视网膜内界膜,并联合膨胀气体全氟丙烷（C3F8）注入.结果 术后最佳矫正视力较术前均明显提高,差异有统计学意义（t =8.969,P=0.000;t=11.210,P=0.000）,而黄斑中心凹视网膜厚度较术前均明显降低,差异有统计学意义（t =7.282,P=0.000;t=9.785,P=0.000）.术前最佳矫正视力、Gass分期、IS/OS层缺损与术后最佳矫正视力相关性分析显示,差异有统计学意义（x2=23.332,P =0.001;x2 =13.043,P=0.042;x2=21.183,P=0.002）.术后发生黄斑板层孔1例,未见黄斑前膜复发与严重并发症.结论 23G微创玻璃体手术治疗黄斑前膜疗效确切,术前视力、临床分期、视网膜IS/OS层结构完整性具有预后意义.Objective To evaluate the efficiency and reliability of 23-gauge pars plana vitrectomy （23G PPV） in treatment of macular epiretinal membrane （MEM） and explore the possible predictor of postoperative visual acuity.Methods A retrospective case series review of 30 eyes undergoing 23G PPV with MEM removal and internal limiting membrane （ILM） peeling and perfluoropropane （C3F8） injection was conducted,including baseline,postoperative at 1st and 3rd month.Results Postoperative best-corrected visual acuity （BCVA） improved significantly （t =8.969,P =0.000;t =11.210,P =0.000）,combined with the postoperative central retinal thickness （CRT） decreased significantly （t =7.282,P =0.000;t =9.785,P =0.000）.Postoperative BCVA was related with preoperative BCVA,clinical stage and IS/OS integrity （x2=23.332,P =0.001;x2=13.043,P =0.042;x2=21.183,P =0.002）.Postoperative lamellar macular hole was detected in one eye.Furthermore,there was no recurrence of MEM or severe complications.Conclusions 23G PPV is safe and effective in treatment of MEM.Preoperative BCVA,clinical stage and IS/OS integrity can be regarded as predictors of postoperative visual acuity.

关 键 词：黄斑前膜 玻璃体手术 

分 类 号：R774.5[医药卫生—眼科]