[1]刘静,朱娟,朱忠桥,等.自体游离内界膜移植术治疗玻璃体切割联合内界膜剥除术后未闭合黄斑裂孔患者的临床疗效[J].眼科新进展,2019,39(8):754-757.[doi:10.13389/j.cnki.rao.2019.0172]
　LIU Jing,ZHU Juan,ZHU Zhong-Qiao,et al.Clinical efficacy of autologous internal limiting membrane fragment transplantation for unclosed macular hole[J].Recent Advances in Ophthalmology,2019,39(8):754-757.[doi:10.13389/j.cnki.rao.2019.0172]
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自体游离内界膜移植术治疗玻璃体切割联合内界膜剥除术后未闭合黄斑裂孔患者的临床疗效/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年8期
页码:
754-757
栏目:
应用研究
出版日期:
2019-08-05

文章信息/Info

Title:
Clinical efficacy of autologous internal limiting membrane fragment transplantation for unclosed macular hole
作者:
刘静; 朱娟; 朱忠桥; 白淑玮; 周卓琳
710004　陕西省西安市，西安市第四医院眼科，陕西省眼科医院，西安交通大学医学院附属广仁医院眼科
Author(s):
LIU Jing; ZHU Juan; ZHU Zhong-Qiao; BAI Shu-Wei; ZHOU Zhuo-Lin
Department of Ophthalmology，Xi’an No.4 Hospital；Shaanxi Ophthalmic Hospital；Department of Ophthalmology of Guangren Hospital，Xi’an Jiao Tong University School of Medicine，Xi’an 710004，Shaanxi Province，China
关键词:
黄斑裂孔; 内界膜移植术; 玻璃体切割术
Keywords:
macular hole; internal limiting membrane transplantation; vitrectomy
分类号:
R774
DOI:
10.13389/j.cnki.rao.2019.0172
文献标志码:
A
摘要:
目的　评价自体游离内界膜移植术治疗玻璃体切割联合内界膜剥除术后未闭合黄斑裂孔患者的临床疗效。方法　本研究为回顾性病例研究。收集2016年3月至2018年6月14例（14眼）玻璃体切割联合内界膜剥除术后未闭合黄斑裂孔患者，行自体游离单层内界膜移植术，将黄斑区外残留的内界膜剥除一片略大于黄斑裂孔直径的游离植片，放置于黄斑裂孔中，并将植片边缘置于裂孔边缘下，起到固定作用，然后行气液交换，术后严格俯卧位3～5 d。术前，术后1 d、2周、1个月、3个月通过频域光学相干断层扫描图像观察黄斑裂孔直径及是否闭合，记录患者最佳矫正视力（best corrected visual acuity，BCVA）和眼压。结果　术后3个月，13眼黄斑裂孔完全闭合，裂孔闭合率为92.9%；1眼黄斑裂孔直径较术前明显缩小，裂孔周围视网膜贴附良好，但黄斑中心凹可见裸露的RPE层，未见神经上皮层组织。术后各时间BCVA较术前明显提高，差异均有统计学意义（均为P<0.05），其中11眼较术前提高，3眼无变化，但所有患者自诉视物变形症状较术前明显好转。术后2周，仅有1眼眼压高，为33.4 mmHg（1 kPa=7.5 mmHg），给予降眼压滴眼液后恢复正常。术后2周所有患者气体均完全吸收。14眼均未出现手术相关并发症。结论　自体游离内界膜移植术治疗玻璃体切割联合内界膜剥除术后未闭合黄斑裂孔，术后裂孔闭合率高，患者视功能改善明显。
Abstract:
Objective　To evaluate the clinical efficacy of autologous internal limiting membrane (ILM) fragment transplantation for unclosed macular hole (MH) after a pars plana vitrectomy（PPV）with ILM peeling.Methods　This was a retrospective case series.Totally 14 eyes of 14 patients with unclosed MH after PPV with ILM peeling from March 2016 to June 2018 were included.All the eyes received autologous monolayer ILM fragment transplantation technique.In the ILM transplantation technique,a fragment of the ILM slightly larger than the diameter of MH was peeled off and transplanted inside the MH,and the edge of the fragment was placed under the edge of the MH.Fluid-air exchange was then performed,and strictly prone position was 3-5 days after surgery.The diameter and closure status of MH were measured with spectral-domain optical coherence tomography,and the best corrected visual acuity (BCVA) and intraocular pressure were recorded before surgery and 1 day,2 weeks,1 month,and 3 months after surgery.Results　Complete MH closure was achieved in 13 eyes at 3 months after surgery,and the closure rate was 92.9%.The diameter of MH in 1 eye was significantly smaller than that before surgery,and the retina around the MH was well adhered,but the exposed RPE layer could be seen in the macular fovea,and no neuroepithelial layer could be observed.BCVA was significantly improved at each time after surgery compared with that before surgery (all P<0.05).Among them,11 eyes were improved and 3 eyes were unchanged.However,all patients presented significantly better visual deformation symptoms than before surgery.Two weeks after surgery,only 1 eye had a high intraocular pressure (33.4 mmHg,1 kPa=7.5 mmHg),which returned to normal after dropping intraocular pressure drops.Air absorption was complete in all patients 2 weeks after surgery.No surgery-related complication was reported in 14 eyes.Conclusion　Autologous ILM fragment transplantation for the treatment of unclosed MH after PPV with ILM peeling has higher anatomic closure rate and obvious improvement of visual function.

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备注/Memo

备注/Memo:
国家自然科学基金资助（编号：81302198）；陕西省自然科学基础研究计划项目（编号：2017JM8082）
更新日期/Last Update: 2019-07-31