【摘要】 目的:比较玻璃切除、内界膜(ILM)撕除翻转覆盖联合空气填充(覆盖组)和玻璃体切除、内界膜单纯剥除联合空气填充(剥除组)治疗特发性黄斑裂孔(IMH)的疗效。方法:确诊IMH的患者,裂孔直径≤400μm共30眼和裂孔直径>400μm共42眼,随机均分为覆盖组和剥除组。观察术前术后患者最佳矫正视力、裂孔闭合情况、裂孔闭合率、并发症等。结果:MH直径≤400μm的患者,术后两组视力均提高,差异无统计学意义(P=0.98),术后所有患者裂孔均闭合,两组间无统计学差异(P>0.05)。MH直径>400μm的患者,术后两组视力均提高,剥除组视力优于覆盖组(P=0.04),剥除组裂孔闭合率高于覆盖组(P=0.022)。两组患者术后均无严重并发症。结论:玻璃体切除、内界膜覆盖联合空气填充能有效治疗IMH,但对于MH直径较大,裂孔分期为Ⅳ期的患者,建议填充惰性气体提高手术成功率。更多还原

【Abstract】 Objective: To compare the effect of vitrectomy,internal boundary membrane( ILM) avulsion and overturn coverage combined with air filling( cover group) and vitrectomy,internal boundary membrane simple stripping combined with air filling( stripping group) for the treatment of idiopathic macular hole( IMH). Methods: For patients with IMH,the diameter of the foramen was smaller than 400 mu m,and the total diameter of the eyes was 30 eyes and the diameter of >400 hole was 42 >400. The best corrected visual acuity,the closure of hiatus,the rate of closure of the foramen and the complications were observed before and after operation. Results: In the patients with MH diameter less than 400 u m,the visual acuity of the two groups increased,the difference was not statistically significant( P = 0.98). All the patients were closed after the operation,and there was no statistical difference between the two groups( P >0.05). The visual acuity of the two groups in the two groups was higher than that of the cover group( P = 0.04),and the closure rate in the stripping group was higher than that of the cover group( P = 0.022). There were no serious complications after operation in the two groups. Conclusion: Vitrectomy,internal boundary membrane cover combined with air filling can effectively treat IMH,but for patients with larger MH diameter and Ⅳstage with split hole stage,it is suggested that inert gas should be filled to improve the success rate.更多还原