摘要
目的评估内界膜(ILM)翻转遮盖术与ILM剥除术在特发性黄斑裂孔(IMH)手术中的效果,观察2种手术方法对黄斑裂孔闭合方式及术后视力的影响。方法回顾性分析2021年6月—2022年3月于我院就诊的IMH患者54例(54眼)的临床资料。根据不同手术方式将患者分为2组,采用ILM剥除术28例(28眼),采用ILM翻转遮盖术26例(26眼),比较2组患者术后6个月时最佳矫正视力(BCVA)、黄斑孔闭合形态及视网膜外层结构。结果术后6个月时,剥除组和翻转组平均视力(LogMAR)分别为0.85±0.25和0.71±0.19,2组视力较术前均有所提高,差异有统计学意义(t_(1)=12.67,P1<0.001;t_(2)=11.47,P_(2)<0.001)。术后视力翻转组较剥除组更好(t=2.20,P=0.033)。术后6个月时,剥除组黄斑裂孔(MH)成功闭合24例(85.7%),其中U型闭合11例(45.8%),EZ完整10例(41.7%),外界膜(ELM)完整17例(70.8%);翻转组MH成功闭合24例(92.3%),U型闭合18例(75.05%),EZ完整16例(66.7%),EIM完整20例(83.3%),翻转遮盖组术后U型闭合及EZ、ELM恢复均高于剥除组。结论2种手术方式在提高MH闭合率方面均有有效性,ILM翻转遮盖术更有利于裂孔沿着原有解剖形态愈合,有效恢复术后视网膜外层结构,提高患者预后视力。
Objective To evaluate the effect of inverted internal limiting membrane(ILM)flap covering and ILM stripping in idiopathic macular hole(IMHs)surgery,and to observe the effect of the two surgical methods on macular hole closure,outer retinal structure and postoperative visual acuity.Methods The clinical data of 54 eyes of 54 patients with IMHs treated in Xuzhou Municipal Hospital from June 2021 to March 2022 were retrospectively analyzed.The patients were divided into two groups according to different surgical methods:28 eyes of 28 patients underwent ILM stripping and 26 eyes of 26 patients underwent ILM inverted covering.The best corrected visual acuity(BCVA),macular hole closure morphology and outer retinal structure were compared between the two groups at 6 months after operation.Results At 6 months after operation,the visual acuity of the two groups was improved compared with that before operation,and the difference was statistically significant(t_(1)=12.67,P1<0.001;t_(2)=11.47,P_(2)<0.001).Postoperative visual acuity in ILM turnover flap group was better than that in ILM stripping group(t=2.20,P=0.033).At 6 months after operation,24(85.7%)cases of macular hole(MH)were successfully closed in the stripping group,including 11(45.8%)cases with U-shaped closure,10(41.7%)cases with intact EZ and 17(70.8%)cases with intact ELM.In the inverted flap group,24(92.3%)cases had MH successful closure,including 18(75.05%)cases of U-type closure,16(66.7%)cases of complete EZ closure,and 20(83.3%)cases of complete EIM closure.The proportions of U-type closure,EZ and ELM recovery in the flap cover group were higher than those in the stripping group.Conclusion The two surgical methods are effective in improving the closure rate of MH.The inverted ILM flap covering technique is more conducive to the healing of the macular hole along the original anatomical shape,and it can effectively restore the outer retinal structure after surgery,and improve the prognosis of patients.
作者
唐余
管莉娜
陈嘉玉
韩爽
张正培
TANG Yu;GUAN Lina;CHEN Jiayu;HAN Shuang;ZHANG Zhengpei(Department of Opthalmology,the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University,Xuzhou 221000,China)
出处
《中国眼耳鼻喉科杂志》
2024年第2期134-138,共5页
Chinese Journal of Ophthalmology and Otorhinolaryngology
基金
徐州市卫生健康委科技项目(XWKYHT20200017)。
关键词
特发性黄斑裂孔
内界膜
闭合形态
视网膜外层结构
Idiopathic macular hole
Inner limiting membrane
Closed form
Outer retinal structure
