Résumé
Objective@#To observe the effect of 25G pars plana vitrectomy (PPV) combined with or without internal limiting membrane (ILM) flap and sterile air or perfluoropropane (C3F8) tamponade in the treatment of idiopathic macular hole (IMH).@*Methods@#A retrospective case analysis. From December 2015 to December 2016 in Tianjin Eye Hospital, 101 eyes of 98 consecutive IMH patients who underwent 25G PPV combined with or without ILM flap and sterile air or C3F8 tamponade, were included in this study. All patients underwent BCVA and OCT examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The patients were divided into three groups according to preoperative minimum liner diameter of Hole (MLD) and surgical methods: MLD<400 μm for the group A, 41 eyes of 39 patients, MLD more than 400 μm without ILM flap surgery as the group B, 39 eyes of 38 patients, including 16 eyes tamponaded with air and 23 eyes tamponaded with C3F8, MLD more than 400 μm with ILM flap as the group C, a total of 21 patients of 21 eyes, including 7 eyes tamponaded with air and 14 eyes tamponaded with C3F8. The logMAR BCVA of group A, B and C were 0.82±0.39, 1.11±0.42, 1.25±0.50, respectively. The follow-up times were 1 week, 1 month, 3 month, 6 month and 1 year post operation, BCVA and OCT were performed at each follow-up time. The hole closure rate and BCVA improvement were observed.@*Results@#The postoperative BCVA of group A, B and C was improved obviously,the differences were statistically significant (t=−11.66, −7.52, −4.99; P<0.01). There was no significant difference in improvement of visual acuity between the three groups (A and B, A and C, B and C group: t=0.77, −0.41, 0.28; P=0.44, 0.72, 0.76). 96.94% macular hole closure occurred in 7 days post operation. The postoperative visual acuity improved significantly in 3 mouth after operation,@*Conclusions@#The macular hole closure occurred mainly in 1 week after operation, postoperative visual acuity increased mostly in the 3rd month post operation. There is no advantage of ILM flap in improve postoperative visual acuity of IMH patients with MLD more than 400 μm.
Résumé
Objective To observe the effect of 25G pars plana vitrectomy (PPV) combined with or without internal limiting membrane (ILM) flap and sterile air or perfluoropropane (C3F8) tamponade in the treatment of idiopathic macular hole (IMH).Methods A retrospective case analysis.From December 2015 to December 2016 in Tianjin Eye Hospital,101 eyes of 98 consecutive IMH patients who underwent 25G PPV combined with or without ILM flap and sterile air or C3F8 tamponade,were included in this study.All patients underwent BCVA and OCT examination.The BCVA examination was performed using the international standard visual acuity chart,which was converted into logMAR visual acuity.The patients were divided into three groups according to preoperative minimum liner diameter of Hole (MLD) and surgical methods:MLD＜400 μm for the group A,41 eyes of 39 patients,MLD more than 400 μm without ILM flap surgery as the group B,39 eyes of 38 patients,including 16 eyes tamponaded with air and 23 eyes tamponaded with C3F8,MLD more than 400 μm with ILM flap as the group C,a total of 21 patients of 21 eyes,including 7 eyes tamponaded with air and 14 eyes tamponaded with C3F8.The logMAR BCVA of group A,B and C were 0.82±0.39,1.11 ±0.42,1.25±0.50,respectively.The follow-up times were 1 week,1 month,3 month,6 month and 1 year post operation,BCVA and OCT were performed at each follow-up time.The hole closure rate and BCVA improvement were observed.Results The postoperative BCVA of group A,B and C was improved obviously,the differences were statistically significant (t=-l 1.66,-7.52,-4.99;P＜0.01).There was no significant difference in improvement of visual acuity between the three groups (A and B,A and C,B and C group:t=0.77,-0.41,0.28;P=0.44,0.72,0.76).96.94％ macular hole closure occurred in 7 days post operation.The postoperative visual acuity improved significantly in 3 mouth after operation,Conclusions The macular hole closure occurred mainly in 1 week after operation,postoperative visual acuity increased mostly in the 3rd month post operation.There is no advantage of ILM flap in improve postoperative visual acuity of IMH patients with MLD more than 400 μm.
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Objective To investigate the clinical characteristics of retinal degeneration (RD) with retinal holes and the therapeutic effect of argon laser therapy. Methods The data of argon laser therapy in 210 RD patients (224 eyes) with retinal holes who underwent the treatment in our department were retrospectively analyzed, which was compared with the data of argon laser therapy in 173 RD patients (198 eyes) without retinal holes. Results In RD patients with retinal holes, 89.7% of the patients were less than 60 years old (53.3% males and 46.7% females). Grid-like degeneration was found in 65.6% of the patients in whom 87.5% had the range of degeneration less than 1 quardrant. There were oval-shaped holes in 60.7% of the patients and accompanied with limited rhegmatogenous retinal detachment (LRRD) in 23.7%. Compared with RD patients without retinal holes, the ratio of patients with the age of≥35 years, cystic degeneration, retinal lengthways small plica, and subjective symptoms was higher in RD patients with retinal holes; while the therapeutic effect of argon laser therapy on patients with LRRD was obviously less than whom without retinal holes (P
Résumé
Objective To observe the clinical effects of surgical treatment of retinal detachment(RD) caused by macular hole(MH) in high myopia. Methods The clinical materials of 149 eyes of 149 high myopia patients with RD caused by MH were reviewed. The cases were divided into complete posterior vitreous detachment (PVD) group and incomplete PVD group. The anatomic successful rate of operative treatment was evaluated according to the applications of vitrectomy surgery and non vitrectomy surgery respectively in each group. The visual acuity changes after the operations were also observed. Results The anatomic successful rates were as follow: 77.9% in total cases with vitrectomy surgery and 25.9% with non vitrectomy surgery ( P 0.05). Conclusions The scleral buckling combined with vitrectomy, gas intraocular tamponade and postoperative photocoagulation is an effective and optimal procedure for RD caused by MH in high myopia.