Individualized, spectral domain-optical coherence tomography-guided facedown posturing after macular hole surgery: minimizing treatment burden and maximizing outcome.
Individualized, spectral domain-optical coherence tomography-guided facedown posturing after macular hole surgery: minimizing treatment burden and maximizing outcome.
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黄斑裂孔手术后个体化、谱域光学相干断层扫描引导的面朝下姿势：最小化治疗负担并最大化结果。
DOI：
10.1097/iae.0000000000000087
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Dugel PU
中科院分区：
文献类型：
--
作者：
Yamashita T;Sakamoto T;Yamashita T;Sonoda S;Yamakiri K,Otsuka H;Hisatomi T;Imaki H;Ishibashi T;Dugel PU
目的：评估黄斑裂孔（MH）手术后个体化，光学相干断层扫描引导下的面朝下姿势，以最大限度地减少负担和最大限度地提高outcome.Methods：一项回顾性比较研究。其中107只眼球的直径小于500 μm，接受了玻璃体切割术和气体填充。术后6小时至术后第2天进行光学相干断层扫描检查。在A组中，采用俯卧姿势协议，根据光学相干断层扫描结果确定面朝下姿势的持续时间。A组再分为：A1组，术后需俯卧位; A2组，术后不需俯卧位。当确认MH闭合时，停止面朝下姿势（如有）。如果MH没有关闭，建议采取额外的姿态。结果：单次手术后，A组、A1组和A2组的手术闭合率分别为96.2%、95.8%和97.1%，而B组的手术闭合率为95.2%。平均体位时间A组为42 h，A1组为57 h，A2组为10 h（P< 0.001）。结论：人工晶状体植入术中，人工晶状体植入后，人工晶状体眼的人工晶状体植入时间明显缩短，人工晶状体眼的人工晶状体植入时间明显缩短，人工晶状体眼的人工晶状体植入成功率明显提高。
Purpose:To evaluate the individualized, optical coherence tomography-guided facedown posturing after macular hole (MH) surgery in minimizing the burden and maximizing outcome.Methods:A retrospective comparative study. One hundred and seven consecutive eyes with an MH (< 500 μm) received vitrectomy and gas tamponade. After surgery, optical coherence tomography examination was performed from 6 hours to postoperative Day 2. In Group A, with a pro re nata posturing protocol, the duration of facedown posturing was determined from the optical coherence tomography findings. Group A was subdivided as follows: Group A1, facedown posturing required postoperatively and Group A2, no posturing required. When MH closure was confirmed, facedown posturing (if any) was discontinued. If the MH did not close, additional posturing was advised. Group B was the control group, consisted of 42 consecutive eyes with traditional 7 days of posturing.Results:After a single surgery, Group A had the MH closure rate of 96.2%, 95.8% in Group A1 and 97.1% in Group A2, whereas Group B had the MH closure rate of 95.2%. The average posturing period was 42 hours for Group A, 57 hours for Group A1 and 10 hours for Group A2 (P< 0.001). The MH size was correlated significantly with the closure time (R= 0.47, P= 0.005, Spearman correlation coefficient).Conclusion:A pro re nata posturing protocol achieves a high MH closure rate with a significant reduction of posturing time especially for pseudophakic eyes.