玻璃体切除联合内界膜环形剥除及移植治疗特发性黄斑孔  

Vitrectomy combined with internal limiting membrane annular peeling and transplantation for the treatment of idiopathic macular hole

作　　者：林会儒 肖静 

机构地区：[1]山东医学高等专科学校眼科教研室 山东省鲁南眼科医院,山东临沂276000 [2]临沂市第三人民医院眼科,山东276000

出　　处：《中华眼外伤职业眼病杂志》2018年第2期93-96,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨黄斑区内界膜环形剥除联合内界膜移植治疗巨大特发性黄斑孔的疗效。方法回顾性分析2015年7月至2016年12月52例（52只眼）巨大特发性黄斑孔（直径〉500μm）临床资料。患者随机分为两组，A组（25例）行常规玻璃体切除联合内界膜剥除术，B组（27例）行玻璃体切除联合内界膜环形剥除并内界膜移植术。术后随诊3个月以上。结果术后3个月两组之间视力改善程度比较差异有统计学意义（t=4．000，P=0．030），两组黄斑孔闭合率比较差异有统计学意3Z（χ^2=4．680，P=0．047），两组椭圆体区缺损直径对比差异有统计学意义（t=6．920，P=0．010）。结论玻璃体切除联合内界膜环形剥除及移植可提高巨大特发性黄斑孔闭合率，改善视功能。Objective To investigate the efficacy of internal limiting membrane （ILM） annular peeling and transplantation in the treatment of giant idiopathic macular hole. Methods Data of 52 eyes of 52 cases with giant idiopathic macnlar hole （d 〉 500 μm） from Jnl. 2015 to Dec. 2016 were collected and analyzed retrospectively. They were divided randomly into 2 groups： group A, 25 cases, underwent pars plana vitrectomy combined with ILM peeling, and group B,27 cases, received vitrectomy combined internal limiting membrane peeling and transplantation. After surgery the follow-up time was more than 3 months. Results The visual acuity at 3 months after surgery was 0.86 ＋ 0.27 in group A and 0.62 ±0.16 in group B. The difference was statistically significant（ t=4. 000, P = 0. 030）. Macular hole closure rate was 84% in group A and 100% in group B, The difference was statistically significant （χ^2 =4. 680,P =0.047）. Defect of ellipsoid zone was （842.08±146.64）txm in group A and （513.89 ±85.59）Ixm in group B. The difference was statistically significant （ t = 6. 920, P = 0. 010 ）. Conclusion Vitrectomy combined with annular ILM peeling and transplantation for the treatment of giant idiopathic macular hole can increase the rate of macular hole closure and improve the visual function.

关 键 词：视网膜穿孔 玻璃体切除术 内界膜剥除术 环形 内界膜移植术 

分 类 号：R779.6[医药卫生—眼科]