23G玻璃体切除联合内界膜剥除、消毒空气填充治疗特发性黄斑裂孔  

23G vitrectomy combined with internal limiting membrane stripping and sterile air filling for the treatment of idiopathic macular holes

作　　者：钱龙奇 陈凡[1] QIAN Qi-long;CHEN Fan(Anqing Municipal Hospital Anqing Hospital Affiliated to Anhui Medical University,246000)

机构地区：[1]安庆市立医院安徽医科大学附属安庆医院,安徽安庆246000

出　　处：《实用防盲技术》2022年第3期100-103,共4页Journal of Practical Preventing Blind

基　　金：安庆市2018年第二批自筹经费科技计划项目(科函[2018] 87号),项目编号:2018Z200。

摘　　要：目的 观察消毒空气填充在玻璃体切割(PPV)联合内界膜剥除术中治疗特发性黄斑裂孔(idiopathic macular hole,IMH)的疗效。方法 回顾性对照研究;选取2018年1月-2020年1月就诊安庆市立医院院眼科的符合纳入标准的特发性黄斑裂孔(IMH)患者,行玻璃体切割(PPV)联合内界膜剥除术,共25只眼;观察术后1、3月时高眼压发生情况、黄斑裂孔闭合率、最佳矫正视力(best corrected visual acuity,BCVA)和黄斑区结构重建情况。结果 术后1、3月时,较术前BCVA均有提高,术后一月、三月分别较术前提高0.27±0.067、0.35±0.067,差异有统计学意义(F=14.717,P<0.05);黄斑裂孔闭合率为96%(一例复发);光感受器细胞内外节交界面连接带(EZ)缺损直径较术前均有显著减小,术后一月、三月分别较术前减少124.71±15.81μm、147.75±15.81μm,差异具有统计学意义(F=50.564,P<0.05);术后高眼压发生率为4%。结论 PPV联合内界膜剥除治疗特发性黄斑裂孔安全有效,玻璃体腔消毒空气填充可减少术后高眼压发生率。Objective To observe the efficacy of sterile air filling in the treatment of idiopathic macular hole(IMH) during vitrectomy(PPV) combined with internal limiting membrane stripping.Methods The method refers to a retrospective controlled study.A number of qualified cases,including 25 patients with idiopathic macular hole(IMH),in the Department of Ophthalmology,Anqing Municipal Hospital,during the period from January 2018 to January 2020,were selected.They received the treatment of sterile air filling in vitrectomy(PPV) combined with internal limiting membrane stripping.Observed the occurrence of intraocular hypertension,macular hole closure rate,best corrected visual acuity(BCVA) and macular structural reconstruction at 1 and 3 months after operation.Results The results are as follow:BCVA have been improved comparing with the previous,The first and the third month after surgery increased by 0.27±0.067 and 0.35±0.067 respectively compared with the preoperative month,and the difference has statistically significant meaning(F=14.717,P<0.05).The macular hole closure rate was 96%,except one case of recrudescence.The defect diameter of the photoreceptor cell inner and outer node interface junction zone(EZ) was significantly reduced compared with that before the operation,The first and the third month after surgery,they decreased by 124.71±15.81 μm and 147.75±15.81 μm respectively compared with before surgery,the difference has statistically significant meaning(F=50.564,P<0.05).The incidence of postoperative high intraocular pressure was 4%.Conclusion The conclusions are drawn that the treatment of idiopathic macular hole using the method of PPV combined with internal limiting membrane stripping is safe and effective.The incidence rate of postoperative high intraocular pressure is reduced with sterilized vitreous cavity air filling.

关 键 词：特发性黄斑裂孔 内界膜剥除 消毒空气填充 黄斑结构 

分 类 号：R779.6[医药卫生—眼科]