玻璃体切割联合后巩膜加固术治疗高度近视眼黄斑裂孔性视网膜脱离

Treatment of retinal detachment due to macular hole in high myopia by vitrectomy with posterior sclera reinforcement

摘要:

目的：探讨玻璃体切割联合后巩膜加固治疗高度近视眼黄斑裂孔伴视网膜脱离的方法与疗效 。

方法：于2012-01/2013-12间收集高度近视性黄斑裂孔伴视网膜脱离患者45例45眼，分为玻璃体切割内界膜撕除联合后巩膜加固组(A组)28眼和玻璃体切割内界膜撕除组(B组)17眼。术前分别行视力、眼压、间接检眼镜、OCT检查，术后随访6～12mo，行视力、OCT检查，分别对视力、视网膜复位情况、黄斑裂孔闭合情况进行统计比较。

结果：(1)视力检查：术后视力：A组1.19±0.39，B 组1.51±0.34，二者比较有显著性差异(P<0.05)；(2)术后视网膜复位率：A组 100%，B组88.24%，两者比较无统计学差异；(3)术后黄斑裂孔闭合率：A组 82%，B组53%，两者比较有统计学差异(P<0.05)。

结论：玻璃体切割术联合后巩膜加固术治疗高度近视眼黄斑裂孔伴视网膜脱离的手术方法安全可行，可更好的改善视力，提高黄斑裂孔的闭合率。

Abstract:

AIM: To evaluate the efficacy of the method of vitrectomy combined with posterior sclera reinforcement for retinal detachment due to macular hole in high myopia.

METHODS: From January 2012 to December 2013, in 45 eyes of 45 high myopic patients with retinal detachment due to macular hole, 28 eyes were in group A of vitrectomy with posterior sclera reinforcement and 17 eyes were in group B of vitrectomy. Preoperative examinations included visual acuity, intraocular pressure, indirect ophthalmoscopy and OCT were performed. In follow-up 6 to 12mo, postoperative examinations of visual acuity, OCT were performed and effects of retinal reattachment and macular hole closure were compared between the two groups.

RESULTS:(1)Postoperative examinations: visual acuity was 1.19±0.39 in group A and 1.51±0.34 in group B. The differences were statistically significant(P<0.05).(2)The retinal reattachment rate was 100% in group A and 88.24% in group B. There was no statistical significance between them(P>0.05).(3)The macular hole closure rate was 82% in group A and 53% in group B. The differences were statistically significant(P<0.05).

CONCLUSION: The treatment of vitrectomy with posterior sclera reinforcement is safe and feasible, which could improve visual acuity and increase the rate of macular hole closure in treating retinal detachment due to macular hole in high myopia.