One year clinical results of different surgical methods in the treatment of idiopathic macular hole

Q4 Medicine

中华眼底病杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2019.06.010

Yuyan Liu, Ying Wang, Yan-hua Chu, Hongyan Wang

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Abstract

Objective To observe the effect of 25G pars plana vitrectomy (PPV) combined with or without internal limiting membrane (ILM) flap and sterile air or perfluoropropane (C3F8) tamponade in the treatment of idiopathic macular hole (IMH). Methods A retrospective case analysis. From December 2015 to December 2016 in Tianjin Eye Hospital, 101 eyes of 98 consecutive IMH patients who underwent 25G PPV combined with or without ILM flap and sterile air or C3F8 tamponade, were included in this study. All patients underwent BCVA and OCT examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The patients were divided into three groups according to preoperative minimum liner diameter of Hole (MLD) and surgical methods: MLD<400 μm for the group A, 41 eyes of 39 patients, MLD more than 400 μm without ILM flap surgery as the group B, 39 eyes of 38 patients, including 16 eyes tamponaded with air and 23 eyes tamponaded with C3F8, MLD more than 400 μm with ILM flap as the group C, a total of 21 patients of 21 eyes, including 7 eyes tamponaded with air and 14 eyes tamponaded with C3F8. The logMAR BCVA of group A, B and C were 0.82±0.39, 1.11±0.42, 1.25±0.50, respectively. The follow-up times were 1 week, 1 month, 3 month, 6 month and 1 year post operation, BCVA and OCT were performed at each follow-up time. The hole closure rate and BCVA improvement were observed. Results The postoperative BCVA of group A, B and C was improved obviously,the differences were statistically significant (t=−11.66, −7.52, −4.99; P<0.01). There was no significant difference in improvement of visual acuity between the three groups (A and B, A and C, B and C group: t=0.77, −0.41, 0.28; P=0.44, 0.72, 0.76). 96.94% macular hole closure occurred in 7 days post operation. The postoperative visual acuity improved significantly in 3 mouth after operation, Conclusions The macular hole closure occurred mainly in 1 week after operation, postoperative visual acuity increased mostly in the 3rd month post operation. There is no advantage of ILM flap in improve postoperative visual acuity of IMH patients with MLD more than 400 μm. Key words: Retinal perforation; Vitrectomy; Tomography, optical coherence

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不同手术方法治疗特发性黄斑裂孔一年的临床结果

目的观察25G玻璃体切割(PPV)联合或不联合内限定膜(ILM)皮瓣和无菌空气或全氟丙烷(C3F8)填塞治疗特发性黄斑裂孔(IMH)的效果。方法回顾性分析病例。2015年12月至2016年12月在天津市眼科医院连续行25G PPV联合或不联合ILM皮瓣和无菌空气或C3F8填塞的98例IMH患者101只眼纳入本研究。所有患者均行BCVA和OCT检查。BCVA检查采用国际标准视力表，视力表转换为logMAR视力。根据术前患者分为三组最低衬管孔直径(MLD)和手术方法:MLD < 400μm A组,41 39岁患者的眼睛,MLD超过400μm没有ILM皮瓣手术为B组,38例39眼,包括16眼填塞与空气和23个眼睛与C3F8填塞,MLD超过400μm ILM皮瓣C组,共21例21眼,包括7眼睛填塞与空气和14眼睛与C3F8填塞。A、B、C组的logMAR BCVA分别为0.82±0.39、1.11±0.42、1.25±0.50。随访时间分别为术后1周、1个月、3个月、6个月和1年，每次随访均行BCVA和OCT检查。观察闭孔率和BCVA改善情况。结果A、B、C组术后BCVA明显改善，差异有统计学意义(t= - 11.66， - 7.52， - 4.99;P < 0.01)。三组(A组与B组、A组与C组、B组与C组)视力改善差异无统计学意义:t=0.77， - 0.41, 0.28;P=0.44, 0.72, 0.76)。96.94%的患者术后7天出现黄斑孔闭合。结论黄斑孔闭合主要发生在术后1周，术后视力增加主要发生在术后第3个月。对于MLD大于400 μm的IMH患者，ILM瓣在改善术后视力方面没有优势。关键词:视网膜穿孔;玻璃体切除术;层析成像，光学相干

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).