内界膜剥除治疗特发性黄斑裂孔的长期观察  

Long term outcome of internal limiting membrane removal for treatment of idiopathic macular hole

作　　者：李加青[1] 唐仕波[1] 张淳[1] 罗燕[1] 赖铭莹[1] 马静[1] 

机构地区：[1]中山大学中山眼科中心,510060

出　　处：《中国实用眼科杂志》2003年第8期583-585,共3页Chinese Journal of Practical Ophthalmology

基　　金：卫生部科学基金 (基金号 :961 1 2 3)

摘　　要：目的 :探讨剥除ILM对IMH术后解剖愈合及功能恢复的影响及长期疗效观察。方法 :特发性黄斑裂孔患者 2 6例 ,其中男性 8例 ,女性 18例 ,年龄 3 8～ 73岁 ,平均年龄为 5 7 4岁。根据Gass分期 ,2例Ⅱ期裂孔 ,3例Ⅳ期裂孔 ,其余均为Ⅲ期裂孔。采用标准三切口经睫状体扁平部玻璃体切割术 ,彻底清除玻璃体皮质 ,剥除明显的黄斑前膜 ,然后剥除黄斑区视网膜内界膜 ,最后进行完全气 /液交换 ,C3 F8填充。随访 2 0～ 44个月。结果 :术后 2 6眼中 ,经OCT检查证实黄斑裂孔已完合闭合 2 6眼 (2 6/2 6,闭合率为 10 0 % ) ,2 2例 (84 6% )最佳矫正视力较术前提高 ,2 1例 (80 8% )最佳矫正视力提高 2行以上。随访期间 ,1例出现白内障 ,行超声乳化白内障摘除及人工晶体植入后视力恢复 ,其余患者视力稳定 ,多焦ERG明显改善 ,中心视野无明显改变。结论 :剥除黄斑区ILM ,可以促进特发性黄斑裂孔解剖愈合及功能恢复 ,ILM剥除无长期不良副作用。Objective:To prospectively investigate the effect of healing macular hole of internal limiting membrane (ILM) removal during the surgery for idiopathic macular hole (IMH) and the long term outcome of ILM removal. Methods:Twenty-six consecutive patients (twenty-six eyes) with idiopathic macular hole underwent pars plana vitrectomy (PPV) combined with surgical removal of the epiretinal membranes overlying the hole and ILM surrounding the hole,gas/fluid exchange and C3F8 intraocular tamponade.The follow-up was 20～44 months. Results:In all 26 eyes IMH were completely closed (close rate,100%).22 cases (84.6%) got better postoperative vision and 21 cases (80.8%) had their vision improved more than 2 line.During the follow-up,one patient was found cataract in his operative eye,of which the vision recovered after phacomulcification and IOL implantation.Others had their vision stable.The postoperative M-ERG improved and there were no changes in visual field. Conclusions:PPV is a valid treatment for IMH and the removal of ILM may help IMH close after surgery.ILM removal does not cause any long term side effect.

关 键 词：特发性黄斑裂孔 内界膜剥除 治疗 疗效观察 外科手术 

分 类 号：R774.5[医药卫生—眼科]