自体肝素化全血辅助内界膜撕除的短期评价

Short-term study of autologous heparinized whole blood-assisted internal limiting membrane peeling for macular hole repair

摘要:

目的:评估自体肝素化全血在黄斑裂孔修补术中对视网膜内界膜(internal limiting membrane,ILM)染色的功效。方法:对连续6例7眼特发性黄斑裂孔(idiopathic macularhole,IMH)患者实施自体肝素化全血ILM染色,重点观察全血染色是否有助于ILM撕除。玻璃体切割后,贴近黄斑区视网膜滴自体肝素化全血数滴,移走多余的血液,仅在黄斑区保留一层薄的血膜,然后进行环形撕除。结果:所有6例7眼患者均完成至少术后3mo的随访,平均随访时间5.7mo,术中ILM容易被全血覆盖,撕除过程顺利,覆盖区和无覆盖区形成鲜明对比。所有黄斑裂孔均经一次手术闭合,术中及术后无并发症发生。结论:自体肝素化全血ILM染色,提高了ILM可见度,相对于目前常用的ILM染色剂,全血辅助ILM撕除具有节俭、高效和实用的特点。

Abstract:

AIM:To evaluate the efficacy of autologous heparinized whole blood in assisting internal limiting membrane (ILM) peeling by coating the ILM for idiopathic macular hole (IMH) repair. METHODS:Six patients (7 eyes) with IMH were enrolled in this study. After standard vitrectomy, autologous heparinized whole blood was applied to cover the macula and to coat the surface of the macular area in the fluid-filled vitreous cavity. The redundant blood was removed and only a very thin film of blood was left on the macular area. The blood-coated ILM was removed by forceps. RESULTS:All 7 eyes in 6 patients completed at least 3 months of follow-up. The ILM were coated by autologous heparinized whole blood, removed without difficulty. The whole blood highlighted the contrast of the coated and non-coated areas during the ILM peeling procedure. The IMH were closed in all surgical eyes with a single surgery. No toxic fundus changes were observed during follow-up. CONCLUSION:Autologous heparinized whole blood coat the ILM and facilitate visibility during ILM peeling. Autologous heparinized whole blood is a cost-effective and useful tool for assisting IMH surgery.