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在一次性玻璃切除术失败后,针对异常性黄斑孔的修复手术的结果

Yunhong Shi¹, Lujia Feng², Yangyang Li¹

¹State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.

Frontiers in medicine

|August 14, 2023

概括

持久性异常性黄斑孔 (PIMH) 是一个越来越令人担忧的问题. 用油或空气吸管剥离扩展的内部限制膜在治疗PIMH方面表现出有效性,最小线性直径预测了闭合成功.

科学领域:

眼科医生眼科眼科
视网膜外科手术视网膜外科手术

背景情况:

持久性异常性黄斑孔 (PIMH) 在视网膜手术中是一个重大挑战,在初始治疗失败后,通常需要修改.
标准的半平面玻璃切除术 (PPV) 与内部限制膜 (ILM) 剥离可能并不总是实现黄斑孔的关闭,需要先进的手术策略.

研究的目的:

为了比较使用油 (SiO) 修订PPV的解剖学和功能结果与PIMH的空气吸管.
确定影响手术后PIMH关闭率的因素.

主要方法:

一个追溯的病例系列涉及76名PIMH患者接受了修订PPV.
患者接受了延长ILM剥离的治疗,并与SiO或空气吸管相结合.
用光谱域光学连贯性断层扫描 (SD-OCT) 和最佳校正视敏度 (BCVA) 来进行评估.

主要成果:

解剖学成功率为SiO组的85.7%,空气组的72.7% (p=0.37).
在两个封闭的PIMH子组中,BCVA显著改善 (p<0.001为空气,p=0.041为SiO).
最小线性直径 (MLD) 是关闭的重要预测因素 (OR=1.0,p=0.03),MLD ≤650μm显示更高的关闭率 (88.4%对52%,p=0.002).

结论:

使用SiO或空气吸管进行扩展ILM剥离是PIMH的有效治疗方法.
虽然在本研究中没有统计学意义,但SiO组显示出更好的解剖关闭率的趋势.
MLD是预测PIMH关闭的最关键因素,650μm的值表明成功率明显更高.

关键词:

光学连贯性断层扫描 (optical coherence tomography) 是一种光学连贯性断层扫描技术.帕斯·普拉纳视切除术 (Pars plana vitrectomy) 是一个切除术.持久的异常性黄斑孔.修订程序修订程序视力敏度视力敏度视力敏度

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