笛针负压吸引辅助裂孔闭合技术对大特发性黄斑裂孔的疗效  

Therapeutic effects of flute-needle vacuum assistant hole closure technique for large idiopathic macular hole

作　　者：刘广峰 马志中[1] 马列[1] 姜燕荣 Liu Guangfeng;Ma Zhizhong;Ma Lie;Jiang Yanrong(Department of Ophthalmology,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院眼科,102206

出　　处：《中华实验眼科杂志》2019年第1期45-48,共4页Chinese Journal Of Experimental Ophthalmology

摘　　要：目的观察内界膜剥除联合笛针负压吸引辅助裂孔闭合技术治疗大特发性黄斑裂孔(IMH)的疗效。方法采用回顾性研究设计,收集2017年2月至2018年6月在北京大学国际医院手术治疗的大IMH23例25眼的临床资料,患眼IMH直径为408~939μm,所有患者均接受玻璃体切割术,术中剥除内界膜并采用笛针负压吸引辅助裂孔闭合。评估术眼手术前后最佳矫正视力(BCVA)改变,采用光相干断层扫描(OCT)仪检查IMH闭合形态并测量手术前后视网膜外层外界膜(external limiting membrane,ELM)及椭圆体带(ellipsoid zone,EZ)的缺损长度。结果术后裂孔闭合者25眼,占100%,其中U型闭合16眼,V型闭合9眼。术眼术后1周BCVA为0.76±0.27,优于术前的1.05±0.29,差异有统计学意义(t=3.61,P=0.01)。术眼术后ELM缺损长度平均为(623.32±328.66)μm,较术前的(1050.00±380.39)μm明显缩短,差异有统计学意义(t=6.63,P=0.00)。术眼术后EZ缺损长度平均为(818.28±247.33)μm,较术前的(1147.28±354.41)μm明显缩短,差异均有统计学意义(t=4.12,P=0.00)。结论玻璃体切割术联合内界膜剥除辅助笛针负压吸引治疗大IMH疗效显著,可促进患眼黄斑区视网膜的解剖修复和视功能恢复。Objective To evaluate the therapeutic effects of flute-needle vacuum assistant hole closure technique for large idiopathic macular hole (IMH).Methods The clinical data of 25 eyes with IMH of 408- 939 μm in 23 patients who received pars plana vitrectomy with internal limiting membrane (ILM) peeling and flute-needle vacuum assistant hole closure technique from Feburary in 2017 to June in 2018 in Peking University International Hospital were retrospectively analyzed.The changes of best corrected visual acuity (BCVA) before and after operation were evaluated.The shapes of the hole closure were categorized,and the manifestations of outer retina were observed by optical coherence tomography (OCT),including external limiting membrane (ELM) and ellipsoid zone(EZ).Results The hole closure rate after surgery were 100%(25/25),with the U type closure in 16 eyes and V type closure in 9 eyes.The BCVA was 0.76±0.27 after operation,which was significantly improved in comparison with 1.05± 0.29 before operation (t=3.61,P=0.01).The ELM of OCT image was (1050.00±380.39)μm before operation,and that after operation reduced to (623.32±328.66)μm,showing a significant difference between them (t=6.63,P=0.00).A fully reduced EZ band was seen after operation in comparison with before operation ([1147.28±354.41]μm versus ([818.28±247.33]μm)(t=4.12,P=0.00).Conclusions A combination procedure of vitrectomy with flute-needle vacuum assistant hole closure technique is effective for large IMH,which is beneficial to the anatomical repair and functional recovery of outer retina.

关 键 词：视网膜穿孔/手术 黄斑裂孔 特发性 玻璃体视网膜手术 内界膜剥除 

分 类 号：R779.6[医药卫生—眼科]