25G pars plana vitrectomy combined with peeling of the inner limiting membrane and air tamponade in idiopathic macular hole

中国实用眼科杂志 Pub Date : 2017-04-10 DOI:10.3760/CMA.J.ISSN.1006-4443.2017.04.012

Xiayun Hu, Lina Zhang, Lifang Shen

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Abstract

Objective To evaluate the clinical effect of 25G pars plana vitrectomy with inner limiting membrane peeling and air tamponade for idiopathic macular hole (IMH). Methods Retrospectively examined 28 patients (28 eyes) with IMH in whom 25G vitrectomy, peeling of the inner limiting membrane underwent 0.25mg/ml brilliant blue G(BBG)-assisted, and application of sterile air tamponade were performed. The main observations were the surgical time, best corrected visual acuity (BCVA), intraocular pressure, the healing of macular hole and surgery complications. The follow-up period was 3-24 months (median 12.2±3.6 months). Results The operation lasted for 22-40minutes, meanly 28minutes, 28 cases were all successfully peeled of the inner limiting membrane, macular hole were closed in 28 eyes (100%), visual improvement was achieved in 21 eyes (75%), no eye was worse. The mean BCVA was 0.65±0.194 postoperatively, there was significant statistical differences compared with that before operation (t=13.768, P=0.000). The mean intraocular pressure at postoperative 1 week was (15.3±3.7) mmHg, closed to preoperative level. Eight eyes had punctate retinal hemorrhage when peeling of the inner limiting membrane, 4 eyes had nuclear cataract, 3 eyes had transient higher intraocular pressure, no other serious postoperative complications were observed during the follow-up time in all cases. Conclusions 25G vitrectomy with inner limiting membrane peeling and air tamponade is an effective and safe minimally invasive surgical technique, it can promote healing of macular hole, improve visual acuity, shorten operation time, decrease complication. Key words: 25G vitrectomy; Idiopathic macular hole; Inner limiting membrane peeling

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25G玻璃体切除联合内限定膜剥离及空气填塞

目的评价25G玻璃体切割联合内限定膜剥离和空气填塞治疗特发性黄斑裂孔的临床效果。方法回顾性分析28例(28眼)IMH患者行25G玻璃体切除术，0.25mg/ml亮蓝G(BBG)辅助剥离内限定膜，应用无菌空气填塞。主要观察手术时间、最佳矫正视力(BCVA)、眼压、黄斑孔愈合情况及手术并发症。随访3 ~ 24个月(中位12.2±3.6个月)。结果手术时间22 ~ 40min，平均28min, 28例均成功剥去内限定膜，封闭黄斑孔28眼(100%)，视力改善21眼(75%)，无不良反应。术后平均BCVA为0.65±0.194，与术前比较差异有统计学意义(t=13.768, P=0.000)。术后1周平均眼压为(15.3±3.7)mmHg，与术前水平接近。内限制膜剥离时出现点状视网膜出血8眼，核性白内障4眼，一过性高眼压3眼，随访期间均未见其他严重术后并发症。结论25G玻璃体切除术联合内限定膜剥离和空气填塞是一种安全有效的微创手术技术，可促进黄斑裂孔愈合，提高视力，缩短手术时间，减少并发症。关键词:25G玻璃体切除术;特发性黄斑孔;内限定膜剥离

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中国实用眼科杂志

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期刊介绍： China Practical Ophthalmology was founded in May 1983. It is supervised by the National Health Commission of the People's Republic of China, sponsored by the Chinese Medical Association and China Medical University, and publicly distributed at home and abroad. It is a national-level excellent core academic journal of comprehensive ophthalmology and a series of journals of the Chinese Medical Association. China Practical Ophthalmology aims to guide and improve the theoretical level and actual clinical diagnosis and treatment ability of frontline ophthalmologists in my country. It is characterized by close integration with clinical practice, and timely publishes academic articles and scientific research results with high practical value to clinicians, so that readers can understand and use them, improve the theoretical level and diagnosis and treatment ability of ophthalmologists, help and support their innovative development, and is deeply welcomed and loved by ophthalmologists and readers.