内界膜翻转联合自体血覆盖治疗高度近视黄斑裂孔的疗效观察  

The clinical efficacy of inverted internal limiting membrane flap technique with autologous blood for myopic macular hole

作　　者：陶继伟[1] 徐一珺 沈丽君[1] 余嘉峰 陈亦棋[1] 毛剑波[1] 林丽[1] Tao Jiwei;Xu Yijun;Shen Lijun;Yu Jiafeng;Chen Yiqi;Mao Jianbo;Lin Li(Eye Hospital of Wenzhou Medical University,Hangzhou 310020,China)

机构地区：[1]温州医科大学附属眼视光学院杭州院区,310020

出　　处：《中华眼底病杂志》2019年第6期549-553,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察内界膜(ILM)翻转联合自体血覆盖治疗高度近视黄斑裂孔(MMH)的临床疗效。方法回顾性病例对照研究。2017年1月至2019年5月于温州医科大学附属眼视光学院杭州院区检查确诊并连续治疗的MMH患者29例29只眼纳入研究。其中,男性5例5只眼,女性24例24只眼;平均年龄(55.28±11.40)岁。根据不同的手术方式分为ILM翻转组及ILM常规剥除组,分别为12例12只眼、17例17只眼。所有患者均行BCVA、频域OCT检查及眼轴测量。两组患者年龄、性别、病程、裂孔直径、BCVA等基线资料比较,差异均无统计学意义(P>0.05)。手术后平均随访时间4个月。观察分析两组患者手术后BCVA、裂孔闭合以及中心凹外层结构恢复情况。结果手术后3个月,ILM常规剥除组裂孔闭合11只眼,未闭合6只眼,裂孔闭合率为64.7%;ILM翻转组裂孔闭合12只眼,裂孔闭合率为100.0%。两组裂孔闭合率比较,差异有统计学意义(χ2=5.34,P=0.028)。手术后1、3个月,ILM翻转组BCVA均较手术前明显提高,差异有统计学意义(F=3.813、4.667,P=0.003、0.001)。ILM常规剥除组手术后1个月BCVA较手术前有所提高,但差异无统计学意义(F=1.556,P=0.139);手术后3个月BCVA较手术前明显提高,差异有统计学意义(F=2.453,P=0.026)。两组患者手术后1、3个月BCVA比较,差异均无统计学意义(F=0.647、0.535,P=0.551、0.612)。手术后3个月,两组患者黄斑中心凹外层结构恢复情况比较,差异无统计学意义(F=0.008,P=0.631)。结论ILM翻转联合自体血覆盖治疗MMH安全有效,可显著提高裂孔闭合率。Objective To observe the clinical efficacy of inverted internal limiting membrane(ILM)flap technique with autologous blood for myopic macular hole.Methods A retrospective,case-controlled study.Twenty-nine eyes of 29 patients with myopic macular hole who received treatment in Eye Hospital of Wenzhou Medical University from January 2017 to May 2019 were enrolled in this study.There were 5 males(5 eyes)and 24 females(24 eyes),with an average age of 55.28±11.40 years.According to the surgical method,the patients were divided into inverted ILM flap group(12 eyes)and ILM peeling group(17 eyes).All patients underwent BCVA,spectral domain OCT and axial length measurement before surgery.There was no significant difference between the two groups in age,gender,course of disease,hole diameter,BCVA and other baseline data.Follow-up was over 4 months after surgery.The BCVA,macular hole closure and continuity of outer retina after surgery were observed.Results In ILM peeling group,11 eyes were closed(64.7%)and 6 eyes were not closed at 3 months after surgery.In ILM flap group,12 eyes were closed(100.0%).The difference of closure rate between two groups was statistically significant(χ2=5.34,P=0.028).The BCVA of inverted ILM flap group was significantly improved at 1,3 months after surgery compared with preoperative measurements,and the difference was statistically significant(F=3.813,4.667;P=0.003,0.001).The BCVA of ILM peeling group was improved at 1 month after surgery,but the difference was not statistically significant(F=1.556,P=0.139).And the BCVA was significantly improved at 3 month after surgery compared with preoperative measurements,and the difference was statistically significant(F=2.453,P=0.026).But there was no significant difference in BCVA between the two groups at 1 and 3 months after surgery(F=0.647,0.535;P=0.551,0.612).There was no significant difference in the recovery of outer structure(ELM and EZ continuity)between the two groups at 3 month after surgery(F=0.008,P=0.631).Conclusions Inverted ILM flap techn

关 键 词：内界膜 自体血 黄斑中心凹 病例对照研究 基线资料 眼视光 临床疗效 频域OCT 

分 类 号：R[医药卫生]