[1]杨秀芬,尤冉,汪晓磊,等.玻璃体切割联合视网膜填塞术治疗难治性黄斑裂孔的疗效观察[J].眼科新进展,2018,38(8):783-785.[doi:10.13389/j.cnki.rao.2018.0185]
　YANG Xiu-Fen,YOU Ran,WANG Xiao-Lei,et al.Clinical efficacy of vetrectomy combined with the retina tamping for refractory macular holes[J].Recent Advances in Ophthalmology,2018,38(8):783-785.[doi:10.13389/j.cnki.rao.2018.0185]
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玻璃体切割联合视网膜填塞术治疗难治性黄斑裂孔的疗效观察/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年8期
页码:
783-785
栏目:
应用研究
出版日期:
2018-08-05

文章信息/Info

Title:
Clinical efficacy of vetrectomy combined with the retina tamping for refractory macular holes
作者:
杨秀芬; 尤冉; 汪晓磊; 赵露; 王艳玲
100050　北京市，首都医科大学附属北京友谊医院眼科
Author(s):
YANG Xiu-Fen; YOU Ran; WANG Xiao-Lei; ZHAO Lu; WANG Yan-Ling
Department of Ophthalmology，Beijing Friendship Hospital，Capital Medical University，Beijing 100050，China
关键词:
难治性黄斑裂孔; 内界膜翻瓣术; 内界膜移植
Keywords:
refractory macular holes; inverted internal limiting membrane; internal limiting membrane transplantation
分类号:
R774
DOI:
10.13389/j.cnki.rao.2018.0185
文献标志码:
A
摘要:
目的　观察玻璃体切割联合视网膜填塞术治疗难治性黄斑裂孔的临床疗效。方法　回顾性分析2016年3月至10月就诊于首都医科大学附属北京友谊医院眼科，且诊断为难治性黄斑裂孔、并接受玻璃体切割联合视网膜填塞手术治疗的患者14例（14眼），术后随访3~13个月，使用频域光学相干断层成像评估黄斑裂孔闭合情况，比较术前术后视力。结果　14例（14眼）患者年龄38~73（62.71±8.94）岁，随访3~13（5.78±3.33）个月。其中特发性黄斑大裂孔8例，高度近视黄斑裂孔3例，外伤性黄斑裂孔2例，再次手术1例。行内界膜翻瓣术12例，内界膜移植术2例。术后视力提高者11例，视力提高率为78.57％。术后随访期间，14例（100%）患者黄斑裂孔完全闭合，且随访期内未见裂孔复发，但有2例患者为视网膜色素上皮裸露愈合，裂孔周围视网膜贴附良好。结论　玻璃体切割联合视网膜填塞术可以达到理想的黄斑裂孔闭合率，并对视功能的改善有显著意义。
Abstract:
Objective　To observe the effectiveness of pars plana vetrectomy (PPV) combined with retina tamping for treatment of refractory macular holes.Methods　Retrospective analysis was conducted in fourteen consecutive patients (14 eyes) with refractory macular hole from March to October in 2016 in Ophthalmology of Beijing Friendship Hospital affiliated to Capital Medical University.The patients were followed up for 3-13 months after PPV.The status of macular hole was evaluated by spectral-domain optical coherencetomography (SD-OCT).Preoperative and postoperative visual acuity was compared.The main outcome measures used in this study were MH closure and best-corrected visual acuity (BCVA).Results　The age ranged from 38 to 73 (62.71±8.94)years．The follow-up time after surgery was 3-13 (5.78±3.33) months.The primary diseases in these patients included large idiopathic MH in 8 patients，traumatic MH in 2 patients，high myopic foveoschisis in 3 patients，and secondary surgery in 1 eye.There were 12 patients with the treatment of PPV with inverted internal limiting membrane (ILM) and 2 patients with ILM autologous transplantation.The postoperative BCVAs were significantly better than the preoperative BCVAs in 11 eyes (78.57％).Macular holes were closed successfully in 14 eyes (100%)，while the retinal pigment epitheliums were bare (flat-open macular holes) in 2 patients.There were no ocular or systemic complications observed in all patients．Conclusion　Vitrectomy combined with retina tamping is an effective and safe treatment for the refractory macular holes.

参考文献/References:

［1］　LIU J P，LI X R.New trends of surgical intervention for refractory macular hole［J］.Chin J Ocul Fundus Dis，2016，32（5）：553-556.
刘巨平，李筱荣.难治性黄斑裂孔手术治疗现状与进展［J］.中华眼底病杂志，2016，32（5）：553-556.
［2］　EZRA E，GREGOR Z J，MORFIELDS MACULAR HOLE STUDY GGROUP REPORT N.Surgery for idiopathic full-thickness macular hole：two-year results of a randomized clinical trial comparing natural history，vitrectomy，and vitrectomy plus autologous serum：Morfields Macular Hole Study Group RAeport no.1［J］.Arch Ophthalmol，2004，122（2）：224-236.
［3］　KANG S W，AHN K，HAM D I.Types of macular hole closure and their clinical implications［J］.Br J Ophthalmol，2003，87（8）：1015-1019.
［4］　MICHALEWSKA Z，MICHALEWSKI J，ADELMAN R A，NAWROCKI J.Inverted internal limiting membrane flap technique for large macular holes［J］.Ophthalmology，2010，117（10）：2018-2025.
［5］　MICHALEWSKA Z，MICHALEWSKI J，CISIECKI S，ADELMAN R，NAWROCKI J.Correlation between foveal structure and visual outcome following macular hole surgery：a spectral optical coherence tomography study［J］.Graefes Arch Clin Exp Ophthalmol，2008，246（6）：823-830.
［6］　KURIYAMA S，HAYASHI H，JINGAMI Y，KURAMOTO N，AKITA J，MATSUMOTO M.Efficacy of inverted internal limiting membrane flap technique for the treatment of macular hole in high myopia［J］.Am J Ophthalmol，2013，156（1）：125-131.
［7］　MICHALEWSKA Z，MICHALEWSKI J，DULCZEWSKA K，NAWROCKI J.Inverted internal limiting membrane flap technique for surgical repair of myopic macular holes［J］.Retina，2014，34（4）：664-669.
［8］　MORIZANE Y，SHIRAGA F，KIMURA S，HOSOKAWA M，SHIODE Y，KAWATA T，et al.Autologous transplantation of the internal limiting membrane for refractory macular holes［J］.Am J Ophthalmol，2014，157（4）：861-869.
［9］　CHEN Z，ZHAO C，YE JJ，WANG X Q，SUI R F.Inverted internal limiting membrane flap technique for repair of large macular holes：A short-term follow-up of anatomical and functional outcomes［J］.Chin Med J，2016，129（5）：511-517.
［10］　PIRES J，NADAL J，GOMES N L.Internal limiting membrane translocation for refractory macular holes［J］.Br J Ophthalmol，2017，101（3）：377-382.
［11］　DAI Y，DONG F，ZHANG X，YANG Z.Internal limiting membrane transplantation for unclosed and large macular holes［J］.Graefes Arch Clin Exp Ophthalmol，2016，254（11）：2095-2099.
［12］　DE NOVELLI F J，PRETI R C，RIBEIRO M L，PELAYES D E，JUNQUEIRA N M，TAKAHASHI WY.Autologous internal limiting membrane fragment transplantation for large，chronic，and refractory macular holes［J］.Ophthalmic Res，2015，55（1）：45-52.
［13］　ZHANG X，DONG F T，HE F.One case of autologous internal limiting membrane fragment transplantation for refratory macular hole［J］.Chin J Ophthalmol，2013，49(6)：551-552.
张潇，董方田，贺峰.视网膜内界膜移植治疗复发性黄斑大裂孔一例［J］.中华眼科杂志，2013，49（6）：551-552.
［14］　MICHALEWSKA Z，MICHALEWSKI J，DULCZEWSKA K，ADELMAN R A，NAWROCKI J.Temporal inverted internal limiting membrane flap technique versus classic inverted internal limiting membrane plap technique：A Comparative Study［J］.Retina，2015，35（9）：1844-1850.

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更新日期/Last Update: 2018-08-09