微创玻璃体切割联合内界膜剥除术治疗高度近视黄斑裂孔

目的　观察微创玻璃体切割联合内界膜剥除术治疗高度近视黄斑裂孔的临床效果。方法　回顾性非随机临床对照研究。收集２０１０年１月至２０１５年１月高度近视性黄斑裂孔患者２４例２４眼，同期收集特发性黄斑裂孔患者４３例４３眼作为对照组，两组均行标准三通道经睫状体平坦部２３Ｇ微创玻璃体切割联合内界膜剥除术。观察两组术前及术后最佳矫正视力（ｂｅｓｔｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ，ＢＣＶＡ）及光学相干断层扫描检查黄斑裂孔封闭情况。结果　高度近视性黄斑裂孔组与特发性黄斑裂孔组的解剖闭合率（７９．２％ 和８８．４％）及术后ＢＣＶＡ（ＬｏｇＭＡＲ）（０．５６±０．４２和０．６３±１．３８）比较，差异均无统计学意义（均为Ｐ＞０．０５），两组末次随访时ＢＣＶＡ（ＬｏｇＭＡＲ）分别与治疗前比较，差异均有统计学意义（ｔ＝４．８８６、６．７３５，均为Ｐ＜０．００１）。两组术中均未见医源性裂孔形成，术后无眼内出血或眼内炎等严重并发症发生。结论　玻璃体切割联合内界膜剥除术是修复高度近视眼解剖和功能的有效方式。

Microincision vitrectomy combined with internal limiting membrane peeling for high myopic macular hole

Objective To observe the clinical effects of nucrorncision vitrectomy combined with internal limiting membrane ( ILM) peeling on high myopic macular hole. Methods This was a retrospective non-randomized controlled clinical study. Twentyfour cases ( 24 eyes) with high myopic macular hole from January 2010 to January 2015 were retrospectively reviewed , and another 43 cases ( 43 eyes) with idiopathic macular hole in the same period were collected. All eyes underwent 23G pars plana microincision vitrectomy combined with ILM peeling. The preoperative and postoperative best corrected visual acuity ( BCVA) were observed. and the anatomical closure rate of macular hole was checked by OCT in the two groups. Results The anatomical closure rate of macular hole in high myopic macular hole group and idiopathic macular hole group were 79. 2% .88. 4% , respectively, and the final BCVA ( LogMAR ) were 0. 56 + 0. 42 . 0. 63 + 1. 38 ,respectively, there was no statistical difference ( all P > 0. 05 ) . Compared with pre-operation , there were statistical differences of the post-operative final BCVA of two groups ( t = 4. 886 , 6. 735 . all P < 0. 001 ). In the two groups, no iatrogenic retinal holes formed intraoperatively, and no intraocular hemorrhage or endoophthalnutis happened postoperatively. Conclrision Microincision vitrectomy combined with ILM peeling is a safe and effective surgical treatment for high myopic macular hole.