Correlation Between the Dynamic Postoperative Visual Outcome and the Restoration of Foveal Microstructures After Macular Hole Surgery
Correlation Between the Dynamic Postoperative Visual Outcome and the Restoration of Foveal Microstructures After Macular Hole Surgery
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DOI：
10.1016/j.ajo.2015.03.019
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发表时间：
2015-07-01
影响因子：
4.2
通讯作者：
Wu, Wen-Chuan
中科院分区：
文献类型：
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作者：
Chang, Yo-Chen;Lin, Wei-Ning;Wu, Wen-Chuan
目得：分析接受标准玻璃体切除术治疗特发性黄斑裂孔（MN）的患者1年内视网膜外部变化的长期动态愈合过程。设计：回顾性、连续性、观察性病例系列。收集了56例患者60只眼的数据2011年1月至2012年12月，30名女性，26名男性，因特发性MH接受了成功的睫状体平坦部玻璃体切除术（PPV）和内界膜（ILM）剥离术。年龄分布范围为56 - 85岁（平均：64岁）。40只眼行超声乳化、PPV、ILM剥离和人工透镜植入术; 20只眼术前人工晶状体眼仅行PPV和ILM剥离。主要的结果指标包括logMAR最佳矫正视力（BCVA）和黄斑显微结构，这些都是在术前和术后1、3、6、9和12个月的随访中通过光谱域光学相干断层扫描确定的。术后1个月，24眼（40%）角膜外界膜正常，3个月36眼（60%）角膜外界膜正常，术后12个月ELM正常者54眼（90%）。术后1个月6眼（10%）、3个月18眼（30%）和12个月48眼（80%）显示连续椭圆区（EZ）。在存在完整EZ线的情况下，没有患眼ELM中断。ELM和/或EZ线完整的眼的最佳矫正视力优于ELM或EZ线缺损的眼。相反，胶质细胞呈递与术后BCVA差显著相关。然而，中心凹囊样改变的存在与术后BCVA.CONCLUSIONS：ELM和EZ线在中心凹恢复和胶质细胞和囊样空间的存在逐渐解决手术后。术后视力与神经胶质细胞消退和ELM和EZ线恢复相关。(C)2015年，Elsevier Inc. All rights reserved.
PURPOSE: To analyze the long-term dynamic healing process of outer retinal changes for 1 year in patients who underwent a standard vitrectomy procedure for idiopathic macular hole (MN) repair.DESIGN: Retrospective, consecutive, observational case series.METHODS: Data were collected on 60 eyes of 56 patients (30 women, 26 men) that underwent successful pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling for idiopathic MH from January 2011 to December 2012. The age distribution ranged from 56 to 85 years (mean: 64 years). Forty eyes underwent combined phacoemulsification, PPV, ILM peeling, and intraocular lens implantation; 20 preoperative pseudophakic eyes underwent PPV and ILM peeling only. The main outcome measures included logMAR best-corrected visual acuity (BCVA) and macular microstructures determined by spectral-domain optical coherence tomography performed pre-and postoperatively during follow-up visits at 1, 3, 6, 9, and 12 months.RESULTS: One month after surgery, 24 eyes (40%) showed normal external limiting membrane (ELM), 36 eyes (60%) showed normal ELM at 3 months, and 54 eyes (90%) showed normal ELM 12 months after surgery. Six eyes (10%) revealed a continuous ellipsoid zone (EZ) at 1 month, 18 eyes (30%) at 3 months, and 48 eyes (80%) at 12 months postoperatively. There were no eyes with a disrupted ELM in the presence of an intact EZ line. The eyes with intact ELM and/or intact EZ line showed better BCVA than eyes with defects in ELM or EZ line. On the contrary, glial cell presentation is significantly associated with worse postoperative BCVA. However, the presence of foveal cystoid change is not significantly associated with postoperative BCVA.CONCLUSIONS: The ELM and EZ line at the fovea recovered and the presence of glial cells and cystoid space resolved gradually after surgery. The postoperative visual acuity was correlated with resolved glial cells and a restored ELM and EZ line. (C) 2015 by Elsevier Inc. All rights reserved.