自体血液倒置内限定膜瓣技术治疗近视黄斑裂孔的临床疗效

Q4 Medicine

中华眼底病杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.1005-1015.2019.06.006

J. Tao, Yi-qiang Xu, Lijun Shen, Jia-feng Yu, Yiqi Chen, J. Mao

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There was no significant difference between the two groups in age, gender, course of disease, hole diameter, BCVA and other baseline data. Follow-up was over 4 months after surgery. The BCVA, macular hole closure and continuity of outer retina after surgery were observed. \n \n \nResults \nIn ILM peeling group, 11 eyes were closed (64.7%) and 6 eyes were not closed at 3 months after surgery. In ILM flap group, 12 eyes were closed (100.0%). The difference of closure rate between two groups was statistically significant (χ2=5.34, P=0.028). The BCVA of inverted ILM flap group was significantly improved at 1, 3 months after surgery compared with preoperative measurements, and the difference was statistically significant (F=3.813, 4.667; P=0.003, 0.001). The BCVA of ILM peeling group was improved at 1 month after surgery, but the difference was not statistically significant (F=1.556, P=0.139). 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引用次数: 0

摘要

目的观察自体血倒内限膜(ILM)瓣技术治疗近视黄斑裂孔的临床疗效。方法回顾性、病例对照研究。选取2017年1月至2019年5月在温州医科大学眼科医院就诊的29例近视黄斑孔患者的29只眼作为研究对象。男性5只(5眼)，女性24只(24眼)，平均年龄55.28±11.40岁。根据手术方法将患者分为ILM瓣内翻组(12眼)和ILM剥离组(17眼)。所有患者术前均行BCVA、光谱域OCT和轴长测量。两组患者年龄、性别、病程、孔直径、BCVA等基线资料比较，差异无统计学意义。术后随访超过4个月。观察术后BCVA、黄斑孔闭合及外视网膜连续性。结果ILM剥脱组术后3个月闭眼11眼(64.7%)，未闭眼6眼。ILM皮瓣组闭眼12只(100.0%)。两组间闭合率差异有统计学意义(χ2=5.34, P=0.028)。逆行ILM瓣组术后1、3个月BCVA较术前有明显改善，差异有统计学意义(F=3.813, 4.667;P = 0.003, 0.001)。ILM剥皮组术后1个月BCVA有所改善，但差异无统计学意义(F=1.556, P=0.139)。术后3个月BCVA较术前有明显改善，差异有统计学意义(F=2.453, P=0.026)。但术后1、3个月两组BCVA差异无统计学意义(F=0.647, 0.535;P = 0.551, 0.612)。术后3个月两组外结构恢复(ELM和EZ连续性)差异无统计学意义(F=0.008, P=0.631)。结论自体血液内膜瓣技术是治疗近视黄斑裂孔安全有效的方法。可显著提高井眼闭合率。关键词:近视;退行性/并发症;视网膜穿孔/手术;手术适应症

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The clinical efficacy of inverted internal limiting membrane flap technique with autologous blood for myopic macular hole

Objective To observe the clinical efficacy of inverted internal limiting membrane (ILM) flap technique with autologous blood for myopic macular hole. Methods A retrospective, case-controlled study. Twenty-nine eyes of 29 patients with myopic macular hole who received treatment in Eye Hospital of Wenzhou Medical University from January 2017 to May 2019 were enrolled in this study. There were 5 males(5 eyes) and 24 females (24 eyes), with an average age of 55.28±11.40 years. According to the surgical method, the patients were divided into inverted ILM flap group (12 eyes) and ILM peeling group (17 eyes). All patients underwent BCVA, spectral domain OCT and axial length measurement before surgery. There was no significant difference between the two groups in age, gender, course of disease, hole diameter, BCVA and other baseline data. Follow-up was over 4 months after surgery. The BCVA, macular hole closure and continuity of outer retina after surgery were observed. Results In ILM peeling group, 11 eyes were closed (64.7%) and 6 eyes were not closed at 3 months after surgery. In ILM flap group, 12 eyes were closed (100.0%). The difference of closure rate between two groups was statistically significant (χ2=5.34, P=0.028). The BCVA of inverted ILM flap group was significantly improved at 1, 3 months after surgery compared with preoperative measurements, and the difference was statistically significant (F=3.813, 4.667; P=0.003, 0.001). The BCVA of ILM peeling group was improved at 1 month after surgery, but the difference was not statistically significant (F=1.556, P=0.139). And the BCVA was significantly improved at 3 month after surgery compared with preoperative measurements, and the difference was statistically significant (F=2.453, P=0.026). But there was no significant difference in BCVA between the two groups at 1 and 3 months after surgery (F=0.647, 0.535; P=0.551, 0.612). There was no significant difference in the recovery of outer structure (ELM and EZ continuity) between the two groups at 3 month after surgery (F=0.008, P=0.631). Conclusions Inverted ILM flap technique with autologous blood is a safe and effective method to treat myopic macular hole. The closure rate of the hole can be improved significantly. Key words: Myopia, degenerative/complications; Retinal perforations/surgery; Vitreoretinal surgery

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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).