摘要
目的比较曲安奈德（TA）玻璃体染色辅助玻璃体切除（PPV）联合吲哚青绿（ICG）染色内界膜撕除双重处理对高度近视黄斑裂孔性视网膜脱离（MHRD）视网膜复位及黄斑孔闭合的影响。方法选择43只适度长眼轴（≥26mm、〈29mm）、视网膜色素上皮（RPE）及脉络膜萎缩轻或不明显、无明显的巩膜后葡萄肿的高度近视MHRD眼，将其随机分为TA玻璃体染色辅助PPV联合ICG染色内界膜撕除组（A组，24只眼）和单纯PPV组（B组，19只眼），比较两组间最佳矫正视力（BC—VA）、视网膜复位及黄斑孔闭合率的差异。结果第一次手术，视网膜复位率：A组（91．67％）高于B组（78．95％），但差异无统计学意义（P=0．380）；黄斑孔闭合率：A组58．33％，13组26．32％，差异有统计学意义（P=0．036）；术后视网膜表面膜发生率：B组（26．32％）明显高于A组（4．17％）。经第二次手术，视网膜最终复位率：A组95．83％，B组94．74％（P=1．000）；黄斑孔闭合率：A组58．33％，B组36．84％（P=0．161）；差异均无统计学意义；术后12个月，BCVA提高：A组（58．33％）高于B组（42．11％），但差异无统计学意义（P=0．476）。结论在适度长眼轴、RPE及脉络膜萎缩轻或不明显、无明显的巩膜后葡萄肿的高度近视MHRD眼，TA玻璃体染色辅助PPV联合ICG染色内界膜撕除双重处理有很好的视网膜复位和黄斑孔闭合率。
Objective To compare the outcome of pars plana vitrectomy （PPV） with triamcino- lone （TA） assistance and with Indocyanine green （ICG） staining internal limiting membrane （ILM） peeling for the treatment of highly myopic macular hole retinal detachment （MHRD）. Methods PPV was performed using 2 different surgical procedures in 43 highly myopic MHRD eyes with moderate long axial lengths （AXL）, ＂mild＂ chorioretinal atrophy, and posterior staphyloma.＂ TA-assist- ed PPV and with ICG staining ILM peeling （group A, 24 eyes）, Non-TA assisted PPV and without ILM peeling （group B, 19 eyes）. Anatomic reattachment of the retina, macular hole closure, and best-corrected visual acuity （BCVA） were measured. Results The rates of retinal reattachment and macular hole closure were higher in group A （91.67% and 58.33%） than that in group B （78.95% and 26.32 %） in the first surgery, especially in macular hole closure rate （P =0.036）. The rates of retinal reattachment and macular hole closure were 95.83% and 58.33% （group A）, 94.74% and 36.84% （group B） in the second surgery, and no differences between them. There were no differenc- es of BCVA in group A than that in group B （P =0.977）. Conclusions PPV with TA assistance and ICG staining ILM peeling are effective for the treatment of highly myopic MHRD with moder- ate long AXL, ＂mild＂ chorioretinal atrophy, and posterior staphyloma.
出处
《中国实用眼科杂志》
CSCD
北大核心
2013年第11期1431-1434,共4页
Chinese Journal of Practical Ophthalmology
基金
西安市科委社会发展引导计划-医疗卫生研究项目计划[（SF1022（5））]
