后巩膜加固联合玻璃体切除术治疗高度近视黄斑视网膜劈裂  

Posterior scleral reinforcement combined with vitrectomy for high myopic macular retinoschisis

作　　者：李秀娟[1] 葛自鹏 张金嵩[1] 吕晓贝 贾恒[1] 

机构地区：[1]郑州大学第一附属医院眼科,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2017年第5期321-324,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察后巩膜加固联合玻璃体切除术治疗高度近视黄斑视网膜劈裂的效果。方法高度近视黄斑视网膜劈裂41例（41只眼）行后巩膜加固联合玻璃体切除术。观察术前及术后的最佳矫正视力、屈光度、黄斑中心区视网膜厚度及手术并发症。结果术后随访12个月。术前平均最佳矫正视力为0．92±0．39（10gMAR），随访期末，平均为0．49±0．23（10gMAR），较术前明显提高（t=7．781，P=0．004）。其中，视力提高者34只眼（82．93％），视力不变者7只眼（17．07％）。术后12个月屈光状态为（-15．56±2．71）D，较术前的（-17．89±5．13）D明显降低（t=-5．616，P=0．011）。OCT显示黄斑视网膜劈裂消失38只眼（92．68％），范围缩小3只眼（7．32％）。随访期末黄斑中心区厚度为（198．52±35．64）μm，较术前的（391．42±80．11）μm明显降低（t=88．697，P=0．000）。在随访期间，未发现严重的并发症。结论后巩膜加固联合玻璃体切除术是治疗高度近视黄斑视网膜劈裂安全有效的方法。Objective To observe the efficacy of posterior scleral reinforcement （PSR） combined with vitrectomy for high myopic macular retinoschisis. Methods Forty-one eyes of 41 patients with high myopic macular retinoschisis underwent PSR combined with vitrectomy. Best corrected visual acuity （BCVA）, refraction error, retinal thickness of central macular area and complications were observed and recorded. Results The follow-up period was 12 months. The mean preoperative BCVA was 0.92±0.39 （log MAR）. At the end of follow-up, the mean BCVA was 0.49±0.23 （log MAR） , which significantly improved as compared with the preoperative one （t = 7. 781, P = 0. 004 ）. The BCVA improved in 34 eyes （82.93%）, and unchanged in 7 eyes （ 17.07% ）. At the end of follow-up, the mean refractive error was （ -15.56±2.71） D, and it was significantly lower as compared with the preoperative one （ -17.89± 5.13）D （t = -5. 616, P = 0. 011 ）. OCT showed complete resolution of the macular retinoschisis and a reattachment of the fovea in 38 eyes （92.68%） and partial resolution in the remained 3 eyes （7.32%）. The central macular retinal thickness was obviously reduced at the end of follow-up visit （ 198.52±35.64）μm compared with the preoperative one （391.42±80.11 ）μm （t = 88. 697, P = 0. 000）. There was no serious complication during the follow-up period. Conclusion PSR combined with vitrectomy is an effective and safe method for high myopic macular retinoschisis.

关 键 词：近视 高度 视网膜劈裂 黄斑 后巩膜加固术 玻璃体切除术 

分 类 号：R779.6[医药卫生—眼科]