本文選題：特發(fā)性黃斑裂孔　切入點：玻璃體切割術(shù)　出處：《眼科新進展》2015年05期

【摘要】：目的探討特發(fā)性黃斑裂孔玻璃體切割術(shù)后影響視力恢復(fù)及黃斑解剖愈合的相關(guān)因素。方法 49例49眼特發(fā)性黃斑裂孔行玻璃體切割聯(lián)合內(nèi)界膜剝離術(shù)的患者納入本研究。行最佳矯正視力(best corrected visual acuity,BCVA)(log MAR)檢查、裂隙燈顯微鏡及間接檢眼鏡等檢查,同時采用光學(xué)相干斷層掃描檢測黃斑裂孔基底直徑、裂孔邊緣高度及裂孔最小徑,計算黃斑裂孔指數(shù)(macular hole index,MHI)、黃斑裂孔牽拉指數(shù)(tractional hole index,THI),對黃斑裂孔愈合情況分類。觀察術(shù)后6個月時視力恢復(fù)及黃斑裂孔愈合情況,并與年齡、病程、術(shù)前BCVA、裂孔基底直徑、裂孔高度、裂孔最小徑、MHI、THI等進行相關(guān)性分析。結(jié)果術(shù)后BCVA為(0.45±0.29)log MAR,與術(shù)前BCVA(0.89±0.34)log MAR相比差異具有統(tǒng)計學(xué)意義(t=34.2,P=0.000)。術(shù)后裂孔基底直徑為(432.1±90.7)μm,裂孔邊緣高度為(214.0±81.3)μm,裂孔最小徑為(195.3±86.2)μm,均較術(shù)前明顯減小,差異均有統(tǒng)計學(xué)意義(均為P=0.000);術(shù)后49眼中,裂孔完全愈合者31眼(63.3%),部分愈合者14眼(28.6%),未愈合者4眼(8.2%)。相關(guān)性分析結(jié)果表明,術(shù)后BCVA(log MAR)與年齡、病程、術(shù)前BCVA(log MAR)均無相關(guān)性(均為P0.05),而與MHI、THI顯著相關(guān)(r=0.763,P=0.000;r=0.814,P=0.000);黃斑裂孔愈合類型與裂孔基底直徑、裂孔邊緣高度、裂孔最小徑、MHI、THI均顯著相關(guān)(均為P0.05),而與術(shù)前BCVA、病程、年齡無相關(guān)性(均為P0.05)。結(jié)論MHI、THI可作為預(yù)測術(shù)后視力恢復(fù)及黃斑裂孔愈合的指標。
[Abstract]:Objective to investigate the factors influencing visual acuity and macular anatomic healing after vitrectomy of idiopathic macular hole.Methods 49 cases (49 eyes) of idiopathic macular hole underwent vitrectomy combined with internal membrane dissection.The best corrected visual acuity test, slit lamp microscope and indirect ophthalmoscope were performed. The basal diameter, edge height and minimum diameter of macular hole were examined by optical coherence tomography.The macular hole index (MHI) and the macular hole pulling index (MHI) were calculated. The macular hole healing was classified.The visual acuity and macular hole healing were observed 6 months after operation. The correlation analysis was made with age, course of disease, preoperative BCVA, basal diameter, hiatus height and MHITHI.Results the postoperative BCVA was 0.45 鹵0.29)log Mar, which was significantly higher than that of preoperative BCVA(0.89 鹵0.34)log MAR.The diameter of the basal hole was 432.1 鹵90.7 渭 m, the height of the edge of the hole was 214.0 鹵81.3 渭 m, and the minimal diameter of the hole was 195.3 鹵86.2) 渭 m. The difference was statistically significant (P < 0.01).The hiatus healed completely in 31 eyes (63. 3%), partially healed in 14 eyes (28. 6%), and did not heal in 4 eyes (8. 2%).鐩稿叧鎬у垎鏋愮粨鏋滆〃鏄，

本文編號：1703663