亮蓝辅助内界膜剥离治疗特发性黄斑裂孔的临床观察

亮蓝辅助内界膜剥离治疗特发性黄斑裂孔的临床观察
黄玲;王育良;金青子
【期刊名称】《临床眼科杂志》
【年(卷),期】2013(21)3
【摘要】目的观察亮蓝(BBG)辅助视网膜内界膜(ILM)剥离治疗特发性黄斑裂孔的临床效果及影响因素.方法对2009年6月至2011年7月在我院就诊的一组Ⅲ、Ⅳ期特发性黄斑裂孔患者行玻璃体切割亮蓝辅助内界膜剥离治疗的37例(37只眼)患者的临床资料进行回顾性分析,将术后黄斑裂孔Ⅰ型闭合眼分为A组,黄斑裂孔Ⅱ型闭合眼分为B组,所有病例术前均行常规最佳矫正视力(BCVA)、眼压、裂隙灯显微镜+90D前置镜眼底检查、B型超声、相干光断层扫描(OCT)检查.手术后随访6～16个月,观察患者手术后视力、裂孔闭合形式以及黄斑裂孔直径、厚度对术眼愈后的影响.结果 37例(37只限)特发性黄斑裂孔均闭合,占100％,其中Ⅰ型闭合29只眼(A组),占78.4％,Ⅱ型闭合8只眼(B组),占21.6％,A、B两组手术后的视力较术前视力均提高,差异有统计学意义(P＜0.01),且A组术后视力较B组好(P＜
0.05).A组患眼手术前的黄斑裂孔直径小于B组,两者比较差异有统计学意义(P＜0.01),A组患眼手术前的黄斑裂孔厚度小于B组,两者比较差异有统计学意义(P＜0.05).结论亮蓝辅助视网膜内界膜剥离治疗特发性黄斑裂孔是非常有效的手术方法,黄斑裂孔的直径和厚度是黄斑裂孔愈合的影响因素.%Objective To investigate the clinical efficacy and related factors for brilliant blue G (BBG) assisted internal limiting membrane peeling in the treatment of idiopathic macular holes.Methods A retrospective review consisted of 37 eyes of 37 patients with stage Ⅲ and Ⅳ idiopathic macular holes in 2009 ～ 2011.Pars plana
vitrectomy (PPV) was combined with brilliant blue G (BBG) assisted internal limiting membrane peeling in the treatment of idiopathic macular holes.All the postoperative eyes were classified into the type Ⅰ closure an d the type Ⅱ closure,which considered as group A and group B.Routine examination was performed,including the best corrected visual acuity
(BCVA),intraocular pressure,slit lamp microscope with + 90 D pre-set lens,B-ultrasound,and optical coherence tomography (OCT).The post -surgery follow-up was six to 16 months.The visual outcomes and macular anatomic closure were evaluated,and their relationships with prognostic factors including the size of macular hole and thickness of RNFL in macular hole edge.Postoperative vision and surgical complications were analyzed.Results Anatomic macular hole closure was achieved in 37 eyes (100％).In 29 eyes (78.4％),which considered as group A,macular hole closed as the type Ⅰ closure,and in the other 8 eyes (21.6 ％,group
B),macu lar hole closed as the type Ⅱ closure.The postoperative visual acuity of group A and group B were significantly increased compare to their preoperative measurements (P ＜0.01),and the eyes in group A had better outcomes (P ＜ 0.05).The size of macular hole in group A was significant smaller than that of group B (P ＜ 0.01),and thickness of RNFL in macular hole edge of group A was significantly smaller compared to that of group B (P ＜ 0.05) Conclusion Vitrectomy with BBG-assisted ILM peeling is a safe and effective treatment for idiopathic macular holes.The size of macular hole and thickness of RNFL in macular hole edge are major factor for macular hole outcomes.
【总页数】4页(P229-232)
【作者】黄玲;王育良;金青子
【作者单位】210029南京,江苏省中医院眼科;210029南京,江苏省中医院眼科;210029南京,江苏省中医院眼科
【正文语种】中文
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