有无黄斑中心凹下沉积物的特发性黄斑前膜治疗效果比较  

Subfoveal deposits in idiopathic macular epiretinal membrane

作　　者：黄志坚 陈晓 洪玲 曾苗 HUANG Zhi-Jian;CHEN Xiao;HONG Ling;ZENG Miao(Department of Ophthalmology,Central War Zone General Hospital,Wuhan 430070,Hubei Province,China)

机构地区：[1]中国人民解放军中部战区总医院

出　　处：《眼科新进展》2019年第12期1174-1177,共4页Recent Advances in Ophthalmology

摘　　要：目的对比观察特发性黄斑前膜有无黄斑中心凹下沉积物手术前后情况。方法回顾性非随机临床研究。41例41眼特发性黄斑前膜患者分为2组,组1为有黄斑中心凹下沉积物者8例8眼,组2为没有黄斑中心凹下沉积物者33例33眼。所有患者均接受标准经睫状体平坦部三通道25G玻璃体切割联合内界膜剥除术。对比观察两组术前和术后1个月、3个月、6个月的最佳矫正视力(best corrected visual acuity,BCVA)和黄斑中心凹视网膜厚度(central macular thickness,CMT)情况,同时观察并发症发生情况。结果术后6个月,组1、组2 BCVA分别为(0.65±0.24)logMAR、(0.54±0.26)logMAR,均较术前明显提高,差异有统计学意义(均为P=0.00);两组间术前、术后6个月BCVA差异均无统计学意义(均为P>0.05)。术后6个月,组1、组2 CMT分别为(288.38±64.64)μm、(299.85±37.19)μm,均较术前显著降低,差异均有统计学意义(均为P=0.00);两组间术前、术后6个月CMT相比差异均无统计学意义(均为P>0.05)。随访期间,所有患眼均未见黄斑前膜复发。结论 25G玻璃体切割联合内界膜剥除治疗特发性黄斑前膜,可稳定提高患者的BCVA,促进黄斑结构的恢复,有无黄斑中心凹下沉积物对术后BCVA、CMT无明显影响。Objective To compare the preoperative and postoperative course of subfoveal deposits in idiopathic macular epiretinal membrane(IEM).Methods This retrospective,non-randomised,comparative clinical study.We divided 41 patients(41 eyes) with IEM into 8 eyes of 8 patients with subfoveal deposits as group 1 and 33 eyes of 33 patients without subfoveal deposits as group 2.All patients were treated by 25 G micro-incision vitrectomy and internal limiting membrane(ILM) removal.The changes of the best corrected visual acuity(BCVA),central macular thickness(CMT) were compared at preoperative and postoperative 1,3,6 months.Results At the 6 months after surgery,the mean BCVA was(0.65±0.24)logMAR in group 1,and(0.54±0.26)logMAR in group 2,significant postoperative improvements were observed in both groups(both P=0.00);the difference was not significant in both groups at preoperative and postoperative 6 months(both P>0.05).The mean CMT was(288.38±64.64)μm in group 1,and(299.85±37.19)μm in group 2,significant postoperative improvements were observed in both groups(both P=0.00);the difference was not significant in both groups at preoperative and postoperative 6 months(both P>0.05).No patients of IEM was recurrenced during in 6 months.Conclusion 25 G micro-incision vitrectomy and ILM removal is an efficient and safe treatment for IEM,they can improve BCVA and foveal morphology.Subfoveal deposits does not significantly influence on postoperative BCVA and CMT.

关 键 词：特发性黄斑前膜 黄斑中心凹视网膜厚度 玻璃体切割 黄斑中心凹下沉积物 

分 类 号：R774.5[医药卫生—眼科]