改良式内界膜剥除术治疗视网膜脱离术后视网膜下积液  

Modified internal limiting membrane peeling for subretinal fluid after repair of diabetic tractional retinal detachment

作　　者：温丽蔓 赵洁文 严晓腾 Wen Liman;Zhao Jiewen;Yan Xiaoteng(Department of Ophthalmology,Huai’an Second People’s Hospital,Affiliated Huai’an Hospital of Xuzhou Medical University,Huai’an 223002,China)

机构地区：[1]徐州医科大学附属淮安医院眼科,淮安市第二人民医院眼科,淮安223002

出　　处：《中华眼外伤职业眼病杂志》2023年第9期698-702,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：淮安市自然科学研究计划(联合专项)卫生健康类科研项目(HABL202243)。

摘　　要：目的评估改良式内界膜剥除术治疗牵引性视网膜脱离术后视网膜下积液的效果.方法采用回顾性病例对照研究.分析淮安市第二人民医院2016年1月至2022年12月收治的糖尿病伴牵引性视网膜脱离行玻璃体切除术后出现视网膜下积液者31例(31眼)的临床资料.根据不同手术方法将患者分为两组,采用改良式内界膜剥除术设为A组,15例(15眼);采用常规内界膜剥除术设为B组,16例(16眼).比较两组术后BCVA(logMAR)、视网膜下积液吸收情况.结果术后3个月,A组15例中,视网膜下液吸收14例(93.33%,14/15);B组16例中,视网膜下液吸收14例(87.50%,14/16;χ^(2)=0.30,P=0.583).术后3个月A、B两组BCVA均较术前提高[A组术前、术后3个月分别为:2.21±0.63、1.33±0.54(t=4.14,P<0.01);B组分别为:1.87±0.50、1.42±0.49(t=4.42,P<0.05)].两组术后3个月BCVA差异无统计学意义(t=0.47,P=0.640).结论改良式内界膜剥除术可以有效治疗糖尿病性牵引性视网膜脱离术后视网膜下积液,保存内界膜,改善视力.Objective To evaluate the clinical efficacy of modified internal limiting membrane peeling for subretinal fluid after repair of diabetic tractional retinal detachment.Methods A retrospective case-control study was adopted.The clinical data of 31 eyes of patients with subretinal fluid after repair of diabetic tractional retinal detachment in Huai’an Second People’s Hospital from Jan.2016 to Dec.2022 were analysed.Based on the different surgical methods,these patients were divided into two groups.In group A,15 cases received modified internal limiting membrane peeling.In group B,16 cases received internal limiting membrane peeling.Postoperative best corrected(BCVA)and absorption of subretinal fluid between the two groups were compared.Results At 3 months after operation,absorption of subretinal fluid occurred in 14 cases in group A(93.33%)and 14 cases(87.50%)in group B.The difference was not statistically significant between the two groups(χ^(2)=0.30,P=0.583).BCVA at 3 months after operation improved compared to that before operation[Group A:before operation and 3 months after operation:2.21±0.63,1.33±0.54(t=4.14,P<0.01);Group B:1.87±0.50,1.42±0.49(t=4.42,P<0.05)].BCVA at 3 months postoperatively of the two groups was ameliorated.The difference was not statistically significant between the two groups(t=0.47,P=0.640).Conclusion Compared with internal limiting membrane peeling,internal limiting membrane loosening for subretinal fluid after repair of diabetic tractional retinal detachment can effectively promote subretinal fluid absorption and preserve the internal limiting membrane and improve postoperative vision.

关 键 词：内界膜 液 视网膜下 脱离 视网膜 牵引性 糖尿病性 

分 类 号：R779.6[医药卫生—眼科]