微创玻璃体切除术治疗高度近视黄斑裂孔视网膜脱离的临床疗效  

The clinic effect of transconjunctival sutureless vitrectomy for macular hole retinal detachment in highly myopic eyes

作　　者：孙光丽[1] 徐向忠[1] 沈轶[1] 姚进[1] 

机构地区：[1]南京医科大学附属眼科医院,210000

出　　处：《实用防盲技术》2016年第2期53-55,71,F0004,共5页Journal of Practical Preventing Blind

摘　　要：目的观察23G微创玻璃体切除治疗高度近视黄斑裂孔视网膜脱离的疗效。方法接受23G微创玻璃体切除联合内界膜剥除及硅油填充手术治疗的高度近视黄斑裂孔视网膜脱离的患者21例22眼纳入研究,其中10眼联合白内障手术。术眼的主要观察指标包括Log MAR视力、眼压、OCT、视网膜复位情况及并发症。结果接受23G玻璃体切除联合硅油填充术后一次手术视网膜复位者20眼占90.91%;一次手术后黄斑裂孔闭合者7眼占31.82%;术眼Log MAR视力由术前的1.95±0.44增加到术后的1.57±0.46,差异有统计学意义(P<0.05)。术后短期低眼压者5眼占22.73%;随访中发生高眼压者8眼占36.36%;并发黄斑前膜1眼占4.55%;并发晶体混浊6眼占27.27%。结论高度近视黄斑裂孔视网膜脱离行23G微创玻璃体切除手术,视网膜复位率较高,但黄斑裂孔闭合率相对较低,无严重并发症,手术安全有效。Objective To assess the clinic outcomes of 23 G sutureless vitrectomy for macular hole retinal detachment（MHRD） in highly myopic eyes. Methods A retrospective case series of 21 patients（22 eyes） with MHRD in highly myopic eyes who underwent 23 G vitectomy combined with internal membrane peeling（ILMP）and silicone oil tamponade were included. 10 eyes with cataract had combined phacoemulsification contemporarily. The principal outcome measures were postoperative Log MAR vision, intraocular pressure, primary anatomical success rate, intraoperative and postoperative surgical complications. Results Primary reattachment was achieved in 20 eyes（90.91%）. The macular closure achieved in 7 eyes（31.82%） after the first surgery. The Log MAR vision（mean±SD） improved from 1.95±0.44 preoperatively to 1.57±0.46 postoperatively（P0.05）. Postoperative complications were transient depressed intraocular pressure（IOP） in 5 eyes（22.73%）; elevated IOP in 8 eyes（36.36 %）; macular epiretinal membrane in 1 eye（4.55%）; and opacification of lens in 6 eyes（27.27%）. Conclusion 23 G sutureless vitrectomy for highly myopic MHRD has a high rate of retinal reattachment but relatively low rate of macular hole closure, and is a feasible and safe treatment.

关 键 词：玻璃体切除 高度近视 视网膜脱离 黄斑裂孔 

分 类 号：R779.6[医药卫生—眼科]