后极部玻切微量气体填充治疗黄斑孔效果观察  

Observation on the efficacy of vitrectomy at posterior pole and minimal gas tamponade for the treatment of idiopathic macular hole

作　　者：钱诚[1] 万光明[1] 梁申芝[1] 郑玉宝[1] 刘舒静 Qian Cheng;Wan Guangming;Liang Shenzhi;Zheng Yubao;Liu Shujing(Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Henan Provincial Ophthalmic Hospital, Zhengzhou 450052, Chin)

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2018年第5期325-328,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省卫生科技创新型人才工程中青年科技创新人才项目（201052）

摘　　要：目的 观察后极部局限性玻璃体切除术微量气体填充治疗特发性黄斑孔的临床效果.方法 回顾性分析2013年8月至2015年6月行特发性黄斑孔手术40例（40只眼）的临床资料.手术方式为经睫状体平坦部三切口后极部局限性25 G玻璃体切除术,无染色状态下剥除黄斑区内界膜,玻璃体腔内微量（0.3～0.4 ml）全氟丙烷（C3F8）填充,术后保持面向下体位2周.观察视力、眼压及黄斑区结构.结果 术中无医源性裂孔发生,术后随访6个月,黄斑孔闭合者37只眼（92.50％）,视力提高者35只眼（87.50％）.术前视力（logMAR）平均为0.90±0.46,术后视力提高至0.62±0.33,二者差异有统计学意义（t=3.055,P=0.001）.结论 后极部局限性玻璃体切除术微量惰性气体填充可有效治疗特发性黄斑孔,且手术时间较短,创伤较小.ObjectiveTo observe the efficacy of localized vitrectomy at posterior pole and minimal C3F8 gas tamponade for the treatment of idiopathic macular hole.MethodsThe data of 40 eyes of 40 cases with idiopathic macular hole from Aug. 2013 to Jun. 2015 were collected and analyzed retrospectively. All cases underwent 25-gauge localized vitrectomy at posterior pole, internal limiting membrane peeling without staining and C3F8 gas tamponade （0.3-0.4 ml）. After surgery all cases were required face-down position for 2 weeks. The visual acuity, intraocular pressure and macular structure was observed.ResultsNo iatrogenic retinal tear occurred during surgery. After 6 months follow-up, the macular hole was closed in 37 eyes （92.50%）, and visual acuity was improved in 35 eyes （87.50%）. The average best corrected visual acuity （logMAR） after surgery was increased from 0.90±0.46 to 0.62±0.33, the difference was statistically significant （t=3.055, P=0.001）.ConclusionThe localized vitrectomy at posterior pole and minimal C3F8 gas tamponade is an effective method for idiopathic macular hole, with less traumatic and less time.

关 键 词：玻璃体切除术 黄斑孔 特发性 内界膜剥除术 填充 全氟丙烷 

分 类 号：R779.6[医药卫生—眼科]