Internal limiting membrane dragging and peeling:a modified technique for macular holes closure surgery  

作　　者：Jie Peng Li-Hua Zhang Chun-Li Chen Jing-Jing Liu Xiu-Yu Zhu Pei-Quan Zhao 

机构地区：[1]Department of Ophthalmology,Xinhua Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200092,China [2]Department of Ophthalmology,Binzhou Hubin Aier Eye Hospital,Binzhou 256600,Shandong Province,China [3]Department of Ophthalmology,Eye Institute and School of Optometry,Tianjin Medical University Eye Hospital,Tianjin 200022,China [4]Department of Ophthalmology,Shengli Oilfield Central Hospital,Dongying 257034,Shandong Province,China

出　　处：《International Journal of Ophthalmology(English edition)》2020年第5期755-760,共6页国际眼科杂志（英文版）

基　　金：Supported by the National Natural Science Foundation of China(No.81470642;No.81770964);the Science and Technology Commission of Shanghai Municipality(No.17411952900)。

摘　　要：AIM:To introduce a modified technique of internal limiting membrane(ILM)centripetal dragging and peeling to treat idiopathic macular hole(IMH)and to observe the ILM-retina adhesive forces.METHODS:Twenty-six consecutive patients with stage 3 to 4 IMH and followed up at least six months were enrolled.All patients underwent complete par plana vitrectomy,ILM dragging and peeling,fluid and gas exchange,15%C3 F8 tamponade and 2-week prone position.The best corrected visual acuity,macular hole evaluation by optical coherence tomography,and complications were evaluated.RESULTS:The mean diameter of IMH was 524±148μm(range:201-683μm),with 21 cases(80.8%)greater than 400μm.ILM dragging and peeling were successfully performed in all cases.Most of the ILM-retina adhesive forces are severe(42.3%,11/26),followed by mild(38.5%,10/26),and moderate(19.2%,5/26).The mean follow-up duration was 21.2±6.1 mo.The IMH was closed in 25(96.3%)eyes.Visual acuity(logMAR)improved significantly from 1.2±0.6 preoperatively to 0.7±0.5 postoperatively(P<0.001).CONCLUSION:Preexisting ILM-retina adhesive force is found in IMH patients.With assistance of this force,this modified technique may help to release the IMH edges and improve the closure rate of large IMH.

关 键 词：idiopathic macular hole internal limiting membrane adhesive force par plana vitrectomy 

分 类 号：R779.6[医药卫生—眼科]