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非俯卧位以及大范围内界膜剥除治疗黄斑裂孔的临床观察
The efficacy of broad internal limiting membrane peeling with no face-down positioning in the surgical repair of macular holes
【摘要】 目的 讨论大范围内界膜剥除联合16%全氟丙烷(C3F 8)玻璃体腔填充,术后不采用俯卧位的治疗在黄斑裂孔手术中与传统手术的疗效比较。方法 回顾性分析129例(129眼)黄斑裂孔患者的临床资料。结果 观察组:术前最佳矫正视力(0.16±0.11),术后最佳矫正视力(0.37±0.19)。术前眼压(14.54±8.67)mmHg,术后1周(16.89±2.71)mmHg,术后1个月(14.41±3.08)mmHg,术后3个月(14.11±3.10)mmHg,术后6个月(1 4.16±1.61)mmHg。单纯裂孔封闭率100%。对照组:术前最佳矫正视力(0.16±0.11),术后最佳矫正视力(0.35±0.21)。术前眼压(14.75±5.42)mmHg,术后1周(17.03±2.48)mmHg,术后1个月(14.22±2.37)mmHg,术后3个月(14.03±2.58)mmHg,术后6个月(14.06±1.09)mmHg。随访时有3例裂孔一直未闭合,但未发生视网膜脱离。结论 大范围内界膜剥除+16%C3F8玻璃体腔填充,术后非俯卧位的外科治疗较之于以往的玻璃体腔气体填充以及俯卧位的治疗方式同样有效,且不易复发,消除了以往术后俯卧位引起的一系列病态反应。
【Abstract】 Objective To compare the efficacy of broad internal limiting membrane(ILM) peeling and 16%perfluoropropane(C3F8)endotamponade with no face-down positioning in the surgical repair of macular holes(MHs) with traditional treatment.Methods We analyze 129patients(129 eyes) recruited in this study retrospectively.Results In xexperimental group:the mean preoperative BCVA was 0.16 ±0.11 logarithm of the minim u,m angle of resolution(logMAR) units,and the mean postoperative BCVA was 0.3710.19 logMAR units.Mean preoperative IOP was 14.54 + 8.67 mmHg,mean postoperative IOP was 16.89±2.7ImmHg after one week,14.41 ±3.08 mniHg after one month,14.11 ±3.10 mmHg after 3 months,and 14.16 + 1.61 mmHg after 6 months.The single-procedure MH closure rate was 100%.Control group:mean preoperative BCVA was 0.16 + 0.11 logMAR units,and mean postoperative BCVA was 0.35 ± 0.21 logMAR units.Mean preoperative IOP was 14.75 ± 5.42 mmHg,mean postoperative IOP was 17.03 + 2.48 mmHg after one week,and 14.22 ±2.37 mmHg after one month,14.03 ±2.58 mmHg after 3 moths,and14.06 + 1.09 mmHg after 6 months.3 eyes never had MH closure,but no retina detachment were observed.Conclusions Macular hole surgery with broad ILM peeling,16%C3F8 gas,and no face-down positioning is highly effective in the surgical treatment of MH,with efficacy comparable with methods that use gas endotamponade,face-down positioning,and less recurrence rate.In our series,this method eliminates the morbidity associated with postoperative face-down positioning.
- 【文献出处】 浙江临床医学 ,Zhejiang Clinical Medical Journal , 编辑部邮箱 ,2015年08期
- 【分类号】R779.6