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25G微創玻璃體視網膜手術聯合內界膜剝除治療特發性黃斑裂孔
Idiopathic Macular Hole Managed with 25G Vitreoretinal Surgery and the Internal Limiting Membrane Peeling
摘要
目的：探討採用25G微創玻璃體視網膜手術聯合內界膜剝除治療特發性黃斑裂孔的療效。方法：特發性黃斑裂孔5例（5隻眼），其中男性2例，女性3倒，年齡53歲～64歲．平均年齡為56.6歲。根據Gass分期，2例Ⅱ期裂孔，1例III期裂孔，2例Ⅳ期裂孔。採用標準三切口經睫狀體扁平部25G微創玻璃體視網膜手術方式，Triamcinolone（TA）輔助作玻璃體染色徹底切除玻璃體後皮質，Brilliant Peel作內界膜染色，剝除黃斑區內界膜，最後進行完全氣－液交換及C3F8玻璃體腔填充。所有病例均聯合做白內障超聲乳化摘除及人工晶體植入。術後觀察視力，並進行OCT檢查瞭解黃斑裂孔閉合情况。隨訪8～24個月。結果：5例（5隻眼）術後經OCT檢查證實黃斑裂孔已完合閉合（閉合率為100%），所有病例術後最佳矯正視力均較術前提高2行以上，未見併發症。結論：25G微創玻璃體視網膜手術聯合內界膜剝除治療特發性黃斑裂孔是有效的，可以使特發性黃斑裂孔解剖閉合及提高視力，黃斑區內界膜剝除無不良副作用。
並列摘要
Objective: To observe the effect of the idiopathic macular hole (IMH) managed with 25G vitreoretinal surgery and the internal limiting membrane (ILM) peeling. Methods: This study was designed as an interventional, noncomparative, prospective, clinical case series. Five eyes from 5 consecutive patients with IMH underwent Triamcinolone (TA) assisted vitreous removal completely, Brilliant Peel-assisted ILM peeling, air-liquid exchanged and C3F8 intraocular tamponade. The surgery was combined with phacoemulsification and intraocular lens implantation. All cases were followed up 8 to 24 months. The visual acuity and OCT scan were assessed. Results: Postoperatively, in all 5 eyes IMH were completely closed (close rate 100%) by OCT scan and had the best corrective visual acuities improved more than 2 Snellen lines. No adverse effects were observed postoperatively during the observation period. Conclusion: IMH managed with 25G vitreoretinal surgery and the internal limiting membrane peeling is effective and safe. The best corrective visual acuities are improved. ILM removal does not cause any side effect.