Comparison of internal limiting membrane peeling and flap removal to flap insertion on visual outcomes in highly myopic eyes with macular hole retinal detachment
Comparison of internal limiting membrane peeling and flap removal to flap insertion on visual outcomes in highly myopic eyes with macular hole retinal detachment
复制标题
内界膜剥离、皮瓣去除与皮瓣置入对高度近视黄斑裂孔性视网膜脱离视力结果的比较
DOI：
10.1159/000510150
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发表时间：
2020
期刊：
影响因子：
2.6
通讯作者：
Yamamoto Shuichi
中科院分区：
文献类型：
--
作者：
Iwase Takehito;Baba Takayuki;Kakisu Masato;Yokouchi Hirotaka;Yamamoto Shuichi
简介：比较近视性黄斑裂孔性视网膜脱离（MHRD）眼玻璃体切除术（PPV）联合内界膜（ILM）剥离和皮瓣去除术后的形态和视觉结果与皮瓣插入术后的形态和视力结果。方法：对 45 例 MHRD 患者的 46 只眼睛进行研究。分别采用 PPV 联合 ILM 剥离和皮瓣去除术治疗 18 只眼，并分别采用皮瓣置入术治疗 28 只眼。比较2组的基线特征和术后表现。结果：病例的平均年龄为70.0±8.5岁。皮瓣去除组的最佳矫正视力 (BCVA) 从 1.51 ± 0.14 logMARunits 提高到 1.31 ± 0.20 logMARunits，皮瓣插入组从 1.20 ± 0.10 logMARunits 提高到 0.88 ± 0.10 logMARunits (p= 0.049)。皮瓣插入组中闭合的 MH 数量显着增多（皮瓣插入组中为 96%，去除组中为 50%；p < 0.001）。皮瓣插入组的椭圆体区 (EZ) 和外界膜 (ELM) 的恢复也优于皮瓣去除组 (EZ 14 vs. 6%,p= 0.003; ELM 36 vs. 6%,p< 0.001)。 讨论:ILM 剥离联合皮瓣插入技术更有效地闭合 MH，并获得更好的 BCVA 和更好的 MH 恢复。 外层视网膜微结构优于皮瓣去除。
Introduction:To compare the morphological and visual outcomes after pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling and flap removal to that with flap insertion in eyes with myopic macular-hole retinal detachment (MHRD).Methods:Forty-six eyes of 45 patients with MHRD were studied. Eighteen eyes were treated by PPV with ILM peeling and flap removal and 28 eyes by flap insertion, respectively. The baseline characteristics and postoperative findings were compared between the 2 groups.Results:The average age of the cases was 70.0 ± 8.5 years. The best-corrected visual acuity (BCVA) improved, from 1.51 ± 0.14 to 1.31 ± 0.20 logMARunits in the flap removal group, and from 1.20 ± 0.10 to 0.88 ± 0.10 logMARunits in the flap insertion group (p= 0.049). A significantly larger number of MHs were closed in the flap insertion group (96 vs. 50% in the removed group;p< 0.001). Restoration of the ellipsoid zone (EZ) and external limiting membrane (ELM) was also better in the flap insertion group than in the flap removal group (EZ 14 vs. 6%,p= 0.003; ELM 36 vs. 6%,p< 0.001).Discussion:The technique of ILM peeling with flap insertion is more effective in closing the MH, and results in better BCVA and better restoration of the outer retinal microstructures than flap removal.