RESUMO
·AIM:To compare the effectiveness of inverted internal limiting membrane flap ( ILMF) coverage combined with sterile air tamponade or C3F8-filled surgery for idiopathic macular hole (IMH). ·METHODS: In this retrospective study, 165 patients (175 eyes) who underwent pars plana vitrectomy ( PPV) combined with inverted ILMF coverage were evaluated. The surgeries were performed by one surgeon at the Renmin Hospital, Wuhan University between January 2014 and June 2017. The patients were divided into sterile air (Group A) and C3F8-filled (Group B) groups, based on the technique used for intraocular tamponade. With a minimum 3-month follow-up, pre- and post-operative best corrected visual acuity ( BCVA ), macular hole closure rate, and major postoperative complications were analyzed. · RESULTS: Both groups showed significant improvement in visual acuity at 1 and 3mo postoperatively ( P< 0. 05 ). There was no significant difference between the two groups 1mo postoperatively, but the average BCVA in Group A was better than that in Group B at 3mo, to a level of statistical significance ( P<0. 05). The closure rate of macular hole was 97. 5% in Group A and 96. 8% in Group B, a statistically non-significant difference. There were no statistically significant differences in defect diameters of the inner and outer junctions between the two groups at 1 and 3mo postoperatively(P<0. 05), but significant differences compared to before surgery in both groups (P<0. 05). The rate of IOP elevation was 9. 5% in Group B, and zero ( 0 ) in Group A; this difference was statistically significant (P<0. 05). ·CONCLUSION: We postulate that PPV combined with inverted ILM flap is a safe and effective method for surgical management of IMH. Compared to C3F8-filling, sterile air tamponade can avoid IOP elevation; it may replace C3F8-filling in PPV for IMH.
RESUMO
AIM: To compare the efficacy of vitrectomy combined with internal limiting membrane peeling and C3F8 or sterile air tamponade for idiopathic macular hole (IMH).METHODS: In this research, 51 cases of IMH with holes diameter ≤600μm were accepted from the same doctor of department of Ophthalmology in Luoyang Central Hospital from January 2011 to January 2016.All the patients were under taken vitrectomy combined with internal limiting membrane peeling and gas tamponade.All the study subjects were divided into two groups (Group A and Group B).The Group A were tamponaded with perfluoropropane(C3F8)(27 eyes), while the Group B were tamponaded with sterile air (24 eyes).The closure rate and morphology of macular hole, the time of prone position, the best corrected visual acuity(BCVA), the improvement of metamorphopsia and the process of cataract were compared and statically analyzed in these two groups.While the closure rate was compared among ≤200μm, >200-400μm and >400-600μm groups.Postoperative followup time was 1wk, 1, 3mo and half a year.RESULTS: The difference of two groups was no statistically significant in all interval according to holes diameter (P>0.05).The difference of two groups was no statistically significant in morphology of macular hole form(P>0.05).The time of prone position in Group B was significantly shorter than that in Group A, and the difference was statistically significant(P0.05).The metamorphopsia of postoperative was improved than preoperative in two groups while there was not statistically significant between the two groups in the BCVA of postoperative(P>0.05).Cataract progress rate was reduced in the Group B than the Group A, but the difference was not statistically significant(P>0.05).CONCLUSION: This study shows that sterile air tamponade can obtain same closure rate, morphology of macular hole and the improvement of metamorphopsia and visual function in holes diameter ≤600μm when reducing the time of prone position and the risk of systemic diseases induced by prone position after operation.