摘要
目的 客观评价视网膜内界膜（ILM）剥离手术联合全氟丙烷（C3F8）眼内填充治疗高度近视黄斑劈裂的临床疗效。方法随机选取高度近视黄斑劈裂患者31例33只眼，手术前屈光度-9．5～21．0D，平均屈光度（-13．1±-3．6）D，眼轴26～32mm，平均眼轴长度（28．3±2．1）mm，均伴有黄斑部的巩膜葡萄肿而不伴有视网膜脱离。手术治疗采用常规20G玻璃体切割手术联合ILM剥离和10％C2F8眼内填充，手术中采用曲安奈德（TA）标记ILM。手术后1、2、3、4、8个月复查，对比观察手术前后最佳矫正中心视力和黄斑部的结构变化。结果手术后1个月开始，黄斑部视网膜劈裂即已显著改善，最佳矫正中心视力获得相应提高，随时间的延长，黄斑部结构无明显变化。手术前及手术后1、2、3、4、8个月黄斑中心凹厚度分别为（327．6±51．7）、（165．2±22．6）、（159．3±28．7）、（167．7±17．1）、（142．7±13．8）、（169．1±19．6）μm。与手术前相比，手术后1～8个月黄斑中心凹的厚度均较手术前显著下降（t=9．21，9．23，9．21，10．67，9．21；P〈0．05），手术后各时间段之间比较，黄斑中心凹厚度差异无统计学意义（P〉0．05），手术后4个月至随访末期，黄斑部劈裂复发3只眼，占9．1％。结论视网膜ILM剥离手术联合C3F8眼内填充可有效治疗高度近视黄斑劈裂；手术后远期劈裂的复发是影响预后的主要因素。
Objective To evaluate the efficacy of vitrectomy with internal limiting membrane（ILM） peeling and perfluoropropane tamponade （C3F8 ） to treat macular retinoschisis in high myopic eyes. Methods 33 eyes of 31 consecutive high myopia patients with macular retinoschisis were selected randomly; all had posterior staphyloma without retinal detachment. The preoperative refractive errors ranged from -9.5 D to -21.0 D with the mean of （13.1±3.6） D. The preoperative axial lengths ranged form 26 mm to 32 mm with the mean of （28.3 ± 2.1） mm. Conventional 20-G vitrectomy was performed with ILM peeling and 10 % C3F8 infusion, ILM was labeled by Triamcinolone （TA）. The best corrected visual acuity （BCVA） and macular structural changes were observed before the surgery, and at 1, 2, 3, 4, 8 months after the surgery. Results Beginning from 1 month after surgery all patients had significant improvement of the macular retinoschisis and BCVA. The macular structure changed very slightly along with the time. The foveal thickness were （327.6±51.7）,（165.2±22.6）,（159.3±28.7）,（167.7±17.1）,（142.7±13.8） and （169.1±19.6）μm respectively before surgery and 1, 2, 3, 4, 8 months after surgery. The mean foveal thickness was reduced significantly at 1-8 months follow-up compared with the preoperational result （t=9.21,9.23,9.21,10.67,9.21; P〈0.05）. The foveal thickness had no significant change at each time-point after surgery. From 4 months after surgery, recurrence of macular retionoschisis was found in 3 eyes （9.1%）. Conclusion Vitrectomy with ILM peeling and C3F8 tamponade is useful to treat macular retinoschisis in high myopic eyes.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2009年第5期341-343,共3页
Chinese Journal of Ocular Fundus Diseases
基金
浙江省自然科学基金（491020-N20527）
浙江省卫生厅科技项目（2004A047）
