摘要
目的观察玻璃体切割术中使用吲哚菁绿染色与无染色内界膜剥除术治疗特发性黄斑裂孔的疗效及并发症。方法回顾性分析2006年1月至2009年3月于我院眼科行玻璃体切割联合视网膜内界膜剥除术治疗的特发性黄斑裂孔患者共计88例94眼,其中染色组55例59眼,术中使用吲哚菁绿辅助剥除内界膜;无染色组33例35眼,术中不使用染色剂。比较两组术后黄斑区视网膜最大厚度、黄斑裂孔闭合及视网膜复位情况,最佳矫正视力提高情况,剥除视网膜内界膜手术时间,mfERG变化情况。结果随访至术后12个月时,两组患者黄斑裂孔均完全闭合、视网膜均复位。视网膜最大厚度检测结果显示,染色组与无染色组手术前后厚度的差值相比差异无统计学意义(P>0.05)。染色组术后最佳矫正视力提高2行及以上者40眼(67.8%),无染色组28眼(80.0%);染色组内界膜剥除手术时间为(235.0±9.1)s,无染色组为(168.0±7.4)s,上述两项指标两组比较差异均有统计学意义(均为P<0.05)。两组mfERG一阶函数的1环和2环P1波反应密度均较术前明显增加,与术前相比差异均有统计学意义(均为P<0.05),但染色组增加幅度小于无染色组,两组之间比较差异有统计学意义(P<0.05)。结论与既往应用吲哚菁绿染色行视网膜内界膜剥除术相比较,不染色行视网膜内界膜剥除术也能达到使黄斑裂孔闭合、视网膜脱离复位的目的,且视功能恢复程度更好,手术用时更少,同时避免了染色剂所致的视网膜毒性,适宜广泛应用。
Objective To observe the clinical effects and the complication of in- ternal limiting membrane peeling on idiopathic macular hole in retina with or without indocyanine green staining. Methods A total of 88 cases（94 eyes） from January 2006 to March 2009 in our hospital were retrospectively analyzed and treated with above two kinds of internal limiting membrane peeling respectively in the surgery of vitrectomy on idiopathic macular hole, of which the staining group was 55 cases （ 59 eyes）, the group without staining was 33 cases（ 35 eyes）. The maximum thickness of retina in macular region, the information of macular hole closing and the retina reattachment, the operat- ing time of internal limiting membrane peeling, and the variation of mfERG were com- pared. Results They were followed up till the 12th month after operation, macular hole completely closed and the retina reattachment occurred in all eyes;the detection of the maximum thickness of retina in macular region showed that there was no significant difference between thicknesses of retina in the group with staining and the group with- out staining （P 〉 0.05 ）. The best corrected visual acuity improved above two lines ap- peared in 40 eyes（67.8% ） in the group with staining,and 28 eyes（80.0% ） in the group without staining;the average time of internal limiting membrane peeling of the group with staining was（ 235.0 ± 9.1 ） s, and the group without staining was （ 168.0 ± 7.4 ） s; There was significant difference between the two indexes above （ both P 〈 0.05 ）. The amplitudes of wave P1 of ring 1 and ring 2 by mfERG both increased significantly compared with preoperation（ both P 〈 O. 05 ）, but the increased range or group with stmnmg were less than group wltnout stai- ning, and there was significant difference between the two groups （P 〈 O. 05 ）. Cone｜usion Compared with the group of internal limiting membrane peeling with staining on idiopathic macular hole, the group without staining can also make macu- lar hole closed and the retina reattachment, and furthermore, the group without staining is in favour of the recovery of visual function, needs less operation time, can avoid the toxicity on retina, and is suitable for wide application.
出处
《眼科新进展》
CAS
北大核心
2013年第8期761-764,共4页
Recent Advances in Ophthalmology
