内界膜翻瓣术治疗黄斑裂孔的配对研究  

Paired study on macular hole treated by inverted internal limiting membrane flap technique

作　　者：曹维[1,2] 肖博[1] 王莹[1] 楚艳华[1] 李岩[1] 韩泉洪[1] 

机构地区：[1]天津市眼科医院,天津市300020 [2]天津市北辰医院

出　　处：《眼科新进展》2016年第8期731-734,共4页Recent Advances in Ophthalmology

基　　金：天津市应用基础及前沿技术研究计划项目(编号:15JCYBJC26500)~~

摘　　要：目的用配对研究的方法评价内界膜翻瓣术治疗黄斑裂孔(macular hole,MH)的临床疗效。方法收集2014年10月至2015年6月在天津市眼科医院行玻璃体切割手术的MH患者34例(34眼),将情况相近的患者进行配对,分为两组,A组术中行内界膜翻瓣术、B组术中行内界膜剥除术。术后随访6个月,观察记录术后最佳矫正视力(best-corrected visual acuity,BCVA)、裂孔闭合率、MH闭合形态及椭圆体区闭合率等指标。结果A组术后BCVA为(0.50±0.07)log MAR,明显好于B组(0.91±0.12)log MAR,差异有统计学意义(t=-3.786,P=0.002);A组裂孔闭合率为94.1%(16/17),B组闭合率为70.6%(12/17),差异无统计学意义(P=0.175);A组U型闭合8例,V型闭合7例,W型闭合1例;B组U型闭合4例,V型闭合8例,W型闭合0例;A组椭圆体区闭合率为29.4%,B组椭圆体区闭合率为0,差异有统计学意义(P=0.044)。结论玻璃体切割联合内界膜翻瓣术可提高MH患者术后BCVA和裂孔闭合率,使U型闭合增加,提高椭圆体区术后闭合率,是治疗MH的一种安全、有效的方法。Objective To evaluate the clinical effects of inverted internal limiting membrane（ ILM） flap technique in the treatment of macular hole（ MH） by paired study. Methods Thirty-four patients（ 34 eyes） with MH who underw ent vitrectomy in Tianjin O phthalmological Hospital from O ctober 2014 to June 2015 were collected. The patients with similar conditions were paired and divided into tw o groups（ group A and group B）. Group A underw ent inverted ILMflap technique,and group B underw ent ILMpeeling. All cases were follow ed up for 6months. The best corrected visual acuity（ BC VA）,macular hole closure rate,macular hole closure types and ellipsoid zone closure rate were observed. Results The postoperative BC VA was（ 0. 50 ± 0. 07） log MAR in group A,which was much better than that in group B（ 0. 91 ± 0.12） log MAR,there was statistical difference（ t =- 3. 786,P = 0. 002）. The closure rate was 94.1%（ 16 /17） in group A,and that was 70. 6%（ 12 /17） in group B,there was no statistical difference（ P = 0. 175）. In group A,U-type closures were seen in 8 cases,V-type closures in 7cases and W-type closures in 1 case; In group B,U-type closures were seen in 4 cases,V-type closures in 8 cases,and W-type closures in 0 case. Ellipsoid zone closure rate was 29. 4% in group A,which was much higher than that in group B（ 0）,there was significant difference（ P = 0.044）. Conclusion Vitrectomy combined with inverted ILMflap technique can improve the BC VA and postoperative closure rate for patients with MH,and be good for U-type closure and ellipsoid zone closure. It is a safe and effective method in the treatment of MH.

关 键 词：黄斑裂孔 玻璃体切割 内界膜剥除术 内界膜翻瓣术 

分 类 号：R774.5[医药卫生—眼科]