玻璃体切除术联合地塞米松玻璃体内植入剂治疗特发性黄斑前膜  

Vitrectomy combined with intravitreal injection of Dexamethasone sustained-release agent for the treatment of idiopathic macular epiretinal membrane

作　　者：王爽 白淑玮 雷春灵 李凤至 Wang Shuang;Bai Shuwei;Lei Chunling;Li Fengzhi(Sixth Department of Ophthalmology,Harbin 242 Hospital,Harbin 150066,Heilongjiang Province,China;Xi'an People's Hospital(Xi'an Fourth Hospital)/Shaanxi Eye Hospital/Affiliated People's Hospital of Northwest University,Xi'an 710004,Shaanxi Province,China)

机构地区：[1]中国黑龙江省哈尔滨市二四二医院眼六科,150066 [2]中国陕西省西安市人民医院(西安市第四医院)、陕西省眼科医院、西北大学附属人民医院,710004

出　　处：《国际眼科杂志》2024年第10期1624-1628,共5页International Eye Science

基　　金：陕西省中医药管理局委托办事经费(No.SZY-KJCYC-2023-097)。

摘　　要：目的:研究玻璃体切除术联合地塞米松玻璃体内植入剂治疗特发性黄斑前膜(IMEM)的疗效。方法:回顾性分析2019-01/2023-01在西安市人民医院诊断为IMEM患者72例72眼,按照不同治疗方式分为A组和B组,A组36眼接受玻璃体切除、黄斑前膜(ERM)剥除术联合地塞米松玻璃体内植入剂治疗;B组36眼仅接受玻璃体切除、ERM剥除术治疗。随访12 mo。比较术前及术后1、3、6、12 mo最佳矫正视力(BCVA)、眼压、黄斑中心凹视网膜厚度(CMT)、黄斑视网膜结构变化。结果:术后1、3、6 mo两组间BCVA比较有差异(均P<0.05),A组视力提高较明显;术后12 mo两组间BCVA比较无差异(P=0.056)。术后1、3、6 mo两组间CMT比较有差异(均P<0.05),A组患者术后CMT降低较B组明显;术后12 mo两组间CMT比较无差异(P=0.165)。两组手术前后各时间眼压比较有差异(F时间=2.763,P时间<0.05;F组间=26.800,P组间<0.05;F交互=5.091,P交互<0.05)。A组术后黄斑视网膜结构变化明显。结论:玻璃体手术联合地塞米松玻璃体内植入剂治疗晚期IMEM,能够在术后6 mo内迅速改善黄斑形态并帮助视功能恢复。AIM:To investigate the efficacy of vitrectomy combined with intravitreal injection of dexamethasone sustained-release agent for the treatment of idiopathic macular membrane(IMEM).METHODS:A retrospective analysis was conducted on 72 patients(72 eyes)diagnosed with IMEM at Xi’an People’s Hospital from January 2019 to January 2023.They were divided into Group A and Group B according to different treatment method.Group A,consisting of 36 eyes,underwent vitrectomy,epiretinal membrane(ERM)removal surgery,and dexamethasone intraocular injection treatment;group B(36 eyes)only received vitrectomy and ERM removal surgery.Follow up for 12 mo,the best corrected visual acuity(BCVA),intraocular pressure,central macular thickness(CMT),and changes in macular retinal structure before and at 1,3,6,and 12 mo after surgery were compared.RESULTS:There were significant differences in BCVA between the two groups at 1,3,and 6 mo postoperatively(all P<0.05),with group A showing a more significant improvement in visual acuity;there was no significant difference in BCVA between the two groups at 12 mo after surgery(P=0.056).There were significant differences in CMT between the two groups at 1,3,and 6 mo postoperatively(all P<0.05),with a more significant decrease in CMT of the group A compared with the group B;there was no significant difference in CMT between the two groups at 12 mo after surgery(P=0.165).The comparison of intraocular pressure before and after surgery were all statistically significant(F time=2.763,P time<0.05;F intergroup=26.800,P intergroup<0.05;F interaction=5.091,P interaction<0.05).Group A showed significant structural changes in the macula and retina after surgery.CONCLUSION:Vitreous surgery combined with single intravitreal injection of slow-release dexamethasone in patients with late stage IMEM can rapidly improve macular morphology and help restore visual function within 6 mo after surgery.

关 键 词：特发性黄斑前膜 黄斑水肿 玻璃体内注射 地塞米松 玻璃体切除术 

分 类 号：R779.6[医药卫生—眼科]