Vitrectomy for diabetic macular edema associated with a thickened and taut posterior hyaloid membrane
Vitrectomy for diabetic macular edema associated with a thickened and taut posterior hyaloid membrane
复制标题
DOI：
10.1016/s0002-9394(14)70437-4
复制
发表时间：
1996-04-01
影响因子：
4.2
通讯作者：
Rubsamen, PE
中科院分区：
文献类型：
--
作者：
Harbour, JW;Smiddy, WE;Rubsamen, PE
目的：评估一系列与增厚和拉紧的后玻璃体膜牵引相关的糖尿病黄斑水肿患者的手术结果，并确定与更好视力结果相关的特征。方法：我们回顾了连续 10 名因术前归因于后玻璃体增厚和牵引的糖尿病黄斑水肿而接受扁平部玻璃体切除术的患者的临床记录。 结果：最佳矫正视力，术前七只眼为 20/200，一只眼为 20/300，两只眼为 20/400。术中发现7名患者存在附着后玻璃体膜增厚、拉紧，其中7名患者术后最佳矫正视力2眼提高6行，1眼提高5行，1眼提高2行，3眼与术前视力保持在1行以内，另外3名患者视网膜前膜模拟后玻璃体膜附着增厚。 结论：玻璃体切除术有效地改善了一些患有糖尿病性黄斑水肿的眼睛的视力，这些水肿与增厚和拉紧的后玻璃体膜的牵引有关。然而，尽管术前使用眼底隐形眼镜进行了仔细检查，但在某些患者中，可能很难评估后玻璃体膜如何导致黄斑水肿。在选定的患者中，早期手术干预可能与更好的视力结果相关。
PURPOSE: To evaluate the surgical results in a series of patients with diabetic macular edema associated with traction from a thickened and taut posterior hyaloid membrane and to identify features associated with better visual outcome.METHODS: We reviewed the clinical records of ten consecutive patients who underwent pars plana vitrectomy in one eye for diabetic macular edema that was preoperatively attributed to thickening and traction of the posterior hyaloid membrane.RESULTS: Best corrected, preoperative visual acuity was 20/200 in seven eyes, 20/300 in one eye, and 20/400 in two eyes. Intraoperatively, seven patients were found to have an attached posterior hyaloid membrane which was thickened and taut, Among these seven patients, postoperative best-corrected visual acuity improved by six lines in two eyes, by five lines in one eye, by two lines in one eye, and remained within one line of preoperative visual acuity in three eyes, The other three patients had an epiretinal membrane simulating an attached and thickened posterior hyaloid membrane.CONCLUSIONS: Vitrectomy effectively improved visual acuity in some eyes with diabetic macular edema associated with traction from a thickened and taut posterior hyaloid membrane. Despite careful preoperative examination with a fundus contact lens, however, in some patients it may be difficult to assess how the posterior hyaloid membrane contributes to the macular edema. In selected patients, early surgical intervention may be associated with better visual outcome.