羊膜覆盖治疗复发性高度近视黄斑裂孔性视网膜脱离的临床疗效  

The clinical effect of amniotic membrane patching in the treatment of recurrent macular hole associated with retinal detachment of high myopia

作　　者：梁申芝[1] 董怡辰 万光明[1] 钱诚[1] 王炯[1] 董一[1] Liang Shenzhi;Dong Yichen;Wan Guangming;Qian Cheng;Wang Jiong;Dong Yi(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科,郑州450052

出　　处：《中华眼底病杂志》2022年第6期491-494,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察羊膜覆盖治疗复发性高度近视黄斑裂孔性视网膜脱离(MHRD)的安全性和有效性。方法前瞻性病例研究。2018年3月至2020年1月于郑州大学第一附属医院眼科检查确诊的复发性高度近视MHRD患者11例11只眼纳入研究。其中, 男性3例3只眼, 女性8例8只眼;年龄(63.64±5.82)岁。眼轴长度(AL)(29.10±0.59)mm。最小分辨角对数最佳矫正视力(logMAR BCVA)2.23±0.57。既往曾接受玻璃体切割手术(PPV)联合内界膜剥除手术≥1次。患眼均行标准经睫状体平坦部三通道23G PPV联合羊膜覆盖、硅油填充手术。手术后6个月时取出硅油。随访至硅油取出手术后3个月。手术后1、3、6个月采用手术前相同设备和方法行相关检查, 观察患眼黄斑裂孔闭合、视网膜复位以及logMAR BCVA变化情况。手术前后logMAR BCVA比较行配对t检验。结果手术后1、3、6个月, 所有患眼视网膜均解剖复位, 黄斑裂孔闭合良好, 羊膜与视网膜贴附。硅油取出手术后3个月, 所有患眼黄斑裂孔未复发;logMAR BCVA 1.35±0.32。所有患眼手术中及手术后未见严重并发症发生。结论羊膜覆盖治疗复发性高度近视MHRD安全、有效。Objective To evaluate the safety and efficacy of amniotic membrane patching in the treatment of recurrent macular hole associated with retinal detachment of high myopia(MHRD).Methods A prospective study.From March 2018 to January 2020,11 patients(11 eyes)of recurrent macular hole associated with MHRD at the First Affiliated Hospital of Zhengzhou University were enrolled.Among them,there were 3 males(3 eyes),and 8 females(8 eyes).The average age was 63.64±5.82.The axis length(AL)was 29.10±0.59 mm,and the logarithm of the minimum angle of resolution best corrected visual acuity(logMAR BCVA)was 2.23±0.57.Patients previously received pars plana vitrectomy(PPV)combined with internal limiting membrane stripping surgery,which was more than 1 time.All eyes underwent standard pars plana three-channel 23G PPV combined with amniotic membrane covering and silicone oil filling.The silicone oil was removed 6 months after surgery.Follow-up time was up to 3 months after silicone oil removal surgery.1,3,and 6 months after the operation,the same equipment and methods were used to conduct relevant examinations before the operation to observe the closure of the macular hole,retinal reattachment and changes in logMAR BCVA.The logMAR BCVA before and after surgery was compared by paired t test.Results At 1,3,and 6 months after the operation,the retinas of all eyes were anatomically repositioned,the macular holes were well closed,and the amniotic membrane was attached to the retina.At 3 months after the silicone oil removal operation,there was no recurrence of macular hole in all eyes;logMAR BCVA was 1.35±0.32.No serious complications occurred during and after surgery in all eyes.Conclusion Amniotic membrane patching is a safe and effective method for recurrent macular hole associated with MHRD.

关 键 词：视网膜脱离 视网膜穿孔 近视 退行性 羊膜 

分 类 号：R778.11[医药卫生—眼科]