孔源性视网膜脱离术后黄斑裂孔形成的原因分析  

Causes of macular hole formation after procedures of rhegmatogenous retinal detachment

作　　者：聂玉红 陈震[1] NIE Yuhong;CHEN Zhen(Department of Ophthalmology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei Province,China)

机构地区：[1]武汉大学人民医院眼科中心,湖北省武汉市430060

出　　处：《眼科新进展》2021年第6期563-565,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨孔源性视网膜脱离术后黄斑裂孔形成的原因。方法回顾性分析2017年10月至2019年12月武汉大学人民医院东院眼科所有孔源性视网膜脱离手术患者的临床资料,筛选术后发生黄斑裂孔的患者,结合光学相干断层扫描(OCT)检查结果分析黄斑裂孔形成的原因。结果本研究共纳入孔源性视网膜脱离手术患者409例(423眼),其中行玻璃体切割术者341眼,行巩膜扣带术者78眼,行巩膜环扎术者4眼。回顾性分析发现,423眼视网膜脱离术后共有3眼患者发生黄斑裂孔,发生率为0.71%;其中2眼为玻璃体切割术后发生,裂孔出现时间分别为术后第21天和第30天,发生率为0.59%;1眼为巩膜扣带术后发生,发生时间为术后第5天,发生率为1.28%。所有黄斑裂孔患者均行玻璃体切割联合内界膜剥除术,术后患者黄斑裂孔均愈合,视力均较术前提高。结论孔源性视网膜脱离术后出现黄斑裂孔极其少见,除与视网膜前膜相关外,还与黄斑区视网膜脱离、黄斑区残留玻璃体皮质牵拉和气泡对黄斑区的牵拉有关。Objective To investigate the causes of macular hole formation after surgery for rhegmatogenous retinal detachment.Methods The medical records of all patients undergoing rhegmatogenous retinal detachment surgery in the Department of Ophthalmology,Renmin Hospital of Wuhan University from October 2017 to December 2019 were retrospectively analyzed.We screened out patients with macular holes after surgery,and speculate the causes of macular hole formation by optical coherence tomography(OCT).Results A total of 409 patients(423 eyes)with rhegmatogenous retinal detachment surgery were included in this study,of which 341 eyes underwent vitrectomy,78 eyes underwent scleral buckling,and 4 eyes underwent encirclingscleral buckling.Retrospective analysis showed that macular holes occurred in 3 eyes of 423 eyes undergoing retinal detachment surgery,the incidence was 0.71%.Among them,2 eyes occurred after vitrectomy,and the occurrence time was on day 21 and 30 after the operation,with the incidence being 0.59%.One eye occurred after the scleral buckling,and the occurrence time was on day 5 after the operation,with the incidence of 1.28%.All patients with macular holes underwent vitrectomy with internal limiting membrane peeling.The macular holes were closed and the visual acuity improved.Conclusion Macular hole after rhegmatogenous retinal detachment surgery is rare.In addition to the epiretinal membrane,it is also related to macular-off retinal detachment,residual vitreous cortical traction and the traction of gas bubble on the macular.

关 键 词：孔源性视网膜脱离 玻璃体切割术 巩膜扣带术 黄斑裂孔 

分 类 号：R774.5[医药卫生—眼科]