Observation of cataract extraction and vitrectomy with gas tamponade for idiopathic macular hole at different stages / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

·AIM: To investigate the visual acuity after cataract extraction and vitrectomy with gas tamponade for idiopathic macular hole (IMH) at different stages. ·METHODS: In this study, 75 IMH patients ( 75 eyes ) treated in our hospital from August 2014 to August 2016 were enrolled and underwent cataract extraction, vitrectomy and C3F8gas tamponade. Patients were divided into stage Ⅱ Group ( 18 cases ), stage Ⅲ ( 36 cases) and stageⅣ(21 cases) according to Gass stages, and macular hole closure at 2 and 4wk postoperatively were compared. The routine visual acuity examination before and after surgery were performed, and the visual acuity in each group were compared. The optical coherence tomography ( OCT) was used to measure the macular thickness before and after surgery. ·RESULTS: The closure rate of macular hole in stage Ⅱwas significantly higher than that of stage Ⅲ and IV at the 1mo after operation, that at the stage Ⅲ was significantly higher than that of stageⅣgroup, and the difference was statistically significant (P<0. 05). There was no significant difference in the rate of closure of macular hole between stage Ⅱ and stage Ⅲ at 3mo after operation (P>0. 05). The proportion of eyes with visual acuity of finger counting, 0. 02-0. 08, 0. 10-0. 20, 0. 25-0. 40 and ≥0. 50 was statistically significant different before and after surgery(P<0. 05). The improvement rate of visual acuity was 94% in stage Ⅱ, which was significantly higher than that in stage Ⅲ (83%) and stage Ⅳ (67%). The macular thickness of the stage Ⅱ and Ⅲ was significantly lower after the surgery, but there was no significant difference in the stage Ⅳ before and after surgery (P>0. 05), the decreasing range of the stage Ⅱ and Ⅲ was not statistically significantly different (P>0. 05), which were significantly higher than that of the stage Ⅳ, the difference was statistically significant (P<0. 05). ·CONCLUSION: Cataract extraction, vitrectomy and C3F8 gas tamponade surgery is conducive to the vision recovery after idiopathic macular hole, but the effects with different Gass staging are different, surgery should be performed as early as possible to improve macular hole closure and eyesight recovery.