Three-year outcomes of macular buckling for macular holes and foveoschisis in highly myopic eyes
Three-year outcomes of macular buckling for macular holes and foveoschisis in highly myopic eyes
复制标题
高度近视眼黄斑屈曲治疗黄斑裂孔和黄斑中心凹劈裂的三年结果
DOI：
10.1111/aos.14305
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发表时间：
2019-11-19
影响因子：
3.4
通讯作者：
Lu, Lin
中科院分区：
文献类型：
--
作者：
Zhao, Xiujuan;Ma, Wei;Lu, Lin
目的评估使用硅橡胶海绵-钛外植体治疗高度近视眼黄斑裂孔（FS）和全层黄斑裂孔（FTMH）的功能和结构结局。方法对49例高度近视患者行黄斑加压术治疗FS和FTMH。结果包括解剖成功率，FS分辨率，视网膜复位，MH关闭，最佳矫正视力（BCVA），轴长（AL）和手术并发症。并对年龄、病程、基线视力、视力、手术类型、术前黄斑状态、近视黄斑病变严重程度等因素与术后3年最佳矫正视力的相关性进行分析。结果28例（28眼）FS和21例（21眼）FTMH合并黄斑脱离。视网膜复位率100%，视网膜脱离闭合率76.19%。FS病例在黄斑屈曲后1年和FTMH病例在黄斑屈曲后2年的BCVA显著改善，并且在其余随访期间保持稳定。术后平均AL下降2.09 mm。尽管一名患者因无法忍受的复视而需要取出扣带装置，但没有观察到重大围手术期并发症。结论硅橡胶海绵钛外植体黄斑环压术是治疗高度近视FS和FTMH的一种安全有效的手术方法。黄斑屈曲显示出高闭合率，几乎没有复发的趋势。
Background To assess the functional and structural outcomes of macular buckling using a silicone sponge-titanium exoplant for the treatment of foveoschisis (FS) and full-thickness macular holes (FTMHs) in highly myopic eyes. Methods Forty-nine consecutive patients with high myopia who underwent macular buckling for the treatment of FS and FTMHs were included. The outcomes measured included the anatomical success rate with FS resolution, retinal reattachment, MH closure, best corrected visual acuity (BCVA), axial length (AL) and complications of surgery. Moreover, the correlations between the BCVA at year three and series of factors, including age, duration of symptoms, baseline BCVA, AL, surgical type, preoperative macular status and severity of myopic maculopathy, were analysed. Results This study involved 28 patients (28 eyes) with FS and 21 patients (21 eyes) with FTMHs with macular detachment. Retinal reattachment was achieved in 100% of cases, while MH closure was achieved in 76.19% of cases. The BCVA significantly improved one year after macular buckling in the FS cases and two years after macular buckling in the FTMH cases, and it remained stable throughout the rest of the follow-up period. The mean AL decreased by 2.09 mm postoperatively. No major perioperative complications were observed, although one patient needed to explant the buckling device due to intolerable diplopia. Conclusion Macular buckling with a silicone sponge-titanium exoplant may represent a safe and effective surgical option for the treatment of FS and FTMH in highly myopic eyes. Macular buckling showed a high closure rate and virtually no tendency to recur.