Long-term results of vitrectomy for removal of submacular hard exudates in patients with diabetic maculopathy
Long-term results of vitrectomy for removal of submacular hard exudates in patients with diabetic maculopathy
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DOI：
10.1097/00006982-200402000-00004
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发表时间：
2004-02-01
影响因子：
3.3
通讯作者：
Nakazawa, M
中科院分区：
文献类型：
--
作者：
Takaya, K;Suzuki, Y;Nakazawa, M
目的：探讨玻璃体切除治疗糖尿病黄斑下硬性渗出物的远期疗效。方法：1993年12月至1999年3月，对10例13眼糖尿病黄斑病变患者施行玻璃体切除治疗。术前平均logMAR视力+/-SD为1.54±0.43。术前渗出物直径为0.5~3个，平均1.25个。玻璃体切除后，用视网膜下钳通过微小的黄斑旁视网膜切开术去除渗出物。在所有情况下，添加20%的SF6气体填充物。结果：术后1年7只眼(54%)视力较术前提高，5只眼(38%)长期视力较术前提高。平均最终视力+/-SD为1.62+/-0.59，与对照组相比差异无统计学意义。虽然术后黄斑下硬渗出和黄斑水肿消失，但仍有许多患者出现萎缩或退行性改变。结论：大部分患者在去除黄斑下硬渗出后视力长期不能得到改善，提示糖尿病黄斑病变应在黄斑出现大量渗出沉着之前进行治疗。
Purpose: To investigate long-term results of vitrectomy for the removal of submacular hard exudates in patients with diabetic maculopathy.Methods: Thirteen eyes of 10 patients with diabetic maculopathy underwent vitrectomy to remove submacular hard exudates from December 1993 to March 1999. The mean preoperative logMAR visual acuity +/- SD was 1.54 +/- 0.43. Preoperatively, the exudates ranged from 0.5 to 3 disk diameters (average, 1.25 disk diameters). Exudates were removed using subretinal forceps through a minimal paramacular retinotomy after vitrectomy. In all cases, 20% SF6 gas tamponade was added. The mean postoperative observation period was 43.2 months.Results: Visual acuity was improved in 7 eyes (54%) 1 year after surgery; however, visual acuity over longer periods was improved in only 5 eyes (38%) as compared with the preoperative findings. The mean final visual acuity +/- SD was 1.62 +/- 0.59, which did not show statistically significant improvement over that in the control group. Although submacular hard exudates and macular edema disappeared during the postoperative period, atrophic or degenerative changes occurred in many cases.Conclusion: Visual improvement could not be obtained for a long period after removing submacular hard exudates in most of the patients, suggesting that diabetic maculopathy should be treated before massive exudate deposits appear in the macula.