玻璃体联合内界膜手术治疗黄斑裂孔的效果  

Clinical effect of vitrectomy combined with inverted internal limiting membrane flap in the treatment of idiopathic macular hole

作　　者：张丽娜[1] 黄武[1] 邵慧 李俊[1] 刘青林[1] ZHANG Lina;HUANG Wu;SHAO Hui;LI Jun;LIU Qinglin(LiShui People's Hospital,Zhejiang 323000,China)

机构地区：[1]浙江省丽水市人民医院,丽水323000

出　　处：《浙江创伤外科》2023年第5期836-839,共4页Zhejiang Journal of Traumatic Surgery

基　　金：丽水市科技计划项目(2022GYX38)。

摘　　要：目的 探究玻璃体切除术联合内界膜翻转覆盖术治疗底径>800μm特发性黄斑裂孔的临床效果。方法 将本院收治的106例底径>800μm特发性黄斑裂孔患者以信封法随机分两组,对照组53例(53眼)采用25G玻璃体切除术联合内界膜填塞术治疗;观察组53例(54眼)采用25G玻璃体切除术联合内界膜翻转覆盖术治疗。对比治疗后裂孔闭合率、手术前后的最佳矫正视力变化(BCVA)以及术后并发症情况。结果 观察组治疗后裂孔闭合率98.15%(53/54)明显高于对照组裂孔闭合率79.25%(42/53)(χ^(2)=9.599,P<0.05);术前两组BCVA未见明显差异(P>0.05)。观察组术后1周、术后1个月、术后6个月BCVA均较对照组明显下降(P<0.05);两组术后视网膜裂孔、视网膜脱离、晶状体浑浊发生率对比无明显差异(P>0.05)。结论 玻璃体切除术联合内界膜翻转覆盖术治疗底径>800μm特发性黄斑裂孔患者的临床效果显著,不仅能有效提高裂孔闭合率,还能改善患者视力,且术后并发症少,安全性较高,可在临床推广应用。Objective To explore the clinical effect of vitrectomy combined with inverted internal limiting membrane flap in the treatment of idiopathic macular hole with base diameter 800μm.Methods A total of 106 patients with idiopathic macular hole with base diameter 800μm were randomly divided into two groups by envelope method.The control group(n=53,53 eyes) in the was treated with 25G vitrectomy combined with internal limiting membrane tamping,and the observation group(n=53,54 eyes) was treated with 25G vitrectomy combined with inverted internal limit-ing membrane flap.The macular hole closure rate after treatment,best corrected visual acuity(BCVA) change before and after surgery,and postopera-tive complications were compared.Results The macular hole closure rate was 98.15%(53/54) in the observation group after treatment,which was significantly higher than 79.25%(42/53) in the control group(P<0.05).There was no significant difference in BCVA between the two groups before surgery(P>0.05).The BCVA in the observation group at 1 week,1 and 6 months after surgery were significantly lower than those in the control group(P<0.05).There were no significant differences in the incidence rate of retinal hole,retinal detachment and lens turbidity between the two groups( P>0.05).Conclusion Vitrectomy combined with inverted internal limiting membrane flap has significant clinical effect in the treatment of idiopathic macular hole with base diameter 800μm,it can not only effectively improve the hole closure rate,but also improve the visual acuity of patients,with fewer postoperative complications and high safety,which can be applied in clinical application.

关 键 词：特发性 黄斑裂孔 大底径 玻璃体切除术 内界膜翻转覆盖术 裂孔闭合率 

分 类 号：R779.6[医药卫生—眼科]