Long-term Anatomic and Visual Outcomes of Initially Closed Macular Holes
Long-term Anatomic and Visual Outcomes of Initially Closed Macular Holes
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最初闭合的黄斑裂孔的长期解剖和视觉结果
DOI：
10.1016/j.ajo.2010.11.006
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发表时间：
2011-05-01
影响因子：
4.2
通讯作者：
Jin, Yixuan
中科院分区：
文献类型：
--
作者：
Meng, Qianli;Zhang, Shaochong;Jin, Yixuan
目的：评价玻璃体视网膜手术后黄斑裂孔早期闭合患者的解剖和视力结果。设计：回顾性、非对比、连续病例系列。方法：对79例(87只眼)黄斑裂孔闭合患者进行回顾性临床研究。结果：入选患者年龄49~74岁，平均63.1±6.2岁；黄斑裂孔持续时间0.25~60个月，平均5.6±9.7个月；随访12~86个月，平均38.4±19.7个月。所有患者在玻璃体切除术中均行内界膜剥离，其中(73.6%)行白内障摘除。所有患者均未见黄斑裂孔再次开放。光学相干断层扫描可观察到32.2%(28/87)的病例有轻度裂孔周围视网膜前膜。最终最佳矫正视力提高到最小分辨单位角度的对数0.47+/-0.39，明显高于术前最小分辨单位角度的对数1.01+/-0.36(t=-12.532；P=0.000)。多元线性回归分析显示，黄斑裂孔分期、术前最佳矫正视力和白内障摘除程度对最终最佳矫正视力有影响(F=19.858；P=0.000)。结论：玻璃体切除联合内界膜剥离后，黄斑裂孔稳定闭合。白内障超声乳化联合人工晶状体植入术改善视功能不会导致黄斑裂孔再次开放。《眼科杂志》2011；151：896-900。(C)2011年由Elsevier Inc.保留所有权利。)
PURPOSE: To evaluate the anatomic and visual outcomes in patients with initially closed macular holes after vitreoretinal surgery and with 1 to 7 years of follow-up.DESIGN: Retrospective, noncomparative, consecutive case series.METHODS: Eighty-seven consecutive eyes of 79 patients with previous closure of the macular holes and with at least 1 year of follow-up were reviewed in this retrospective clinical study. Main outcome measures included the rate of macular hole reopening and visual acuity outcomes.RESULTS: The mean age of enrolled patients was 63.1 +/- 6.2 years (range, 49 to 74 years); the mean duration of macular hole was 5.6 +/- 9.7 months (range, 0.25 to 60 months); and the mean follow-up interval was 38.4 +/- 19.7 months (range, 12 to 86 months). All eyes underwent internal limiting membrane peeling during the vitrectomy, and 64 (73.6%) of 87 eyes underwent cataract extraction. No reopening of initially closed macular holes was observed in any eyes. Slight perifoveal epiretinal membranes were observed by optical coherence tomography in 32.2% of cases (28/87). The final best-corrected visual acuity improved to 0.47 +/- 0.39 logarithm of the minimal angle of resolution units, which was significantly higher than preoperative visual acuity of 1.01 +/- 0.36 logarithm of the minimal angle of resolution units (t = -12.532; P=.000). Multiple linear regression analysis demonstrated that the final best-corrected visual acuity was affected by the macular hole stage, preoperative best-corrected visual acuity, and cataract exaction (F = 19.858; P=.000).CONCLUSIONS: The stable closure of macular holes is achieved after vitrectomy with internal limiting membrane peeling. Phacoemulsification cataract surgery with intraocular lens implantation for improvement of visual function is not responsible for the reopening of previously closed macular holes. (Am J Ophthalmol 2011;151:896-900. (C) 2011 by Elsevier Inc. All rights reserved.)