临床眼科杂志2025，Vol.33Issue(2)：97-100,4.DOI:10.3969/j.issn.1006-8422.2025.02.001
特发性黄斑裂孔初次手术闭合率及侧卧位液气交换疗效分析
Primary closure rate of idiopathic macular hole and the efficacy of secondary surgery involving fluid-air ex-change in the lateral position
摘要
Abstract
Objective To investigate the closure rate of primary surgery for idiopathic macular holes and the clini-cal efficacy of secondary surgery involving the fluid-air exchange of lateral position for persistent macular holes.Methods A retrospective analysis was performed.The patients with idiopathic macular hole(IMH)who underwent vitrectomy com-bined with ILM peeling for the first surgery,as well as patients who underwent fluid and 14%C3F8 exchange surgery for un-closed MH after primary surgery from January 2017 to December 2021 in Eye Hospital of Shandong First Medical Univer-sity(Shandong Eye Hospital)were enrolled in the study.The closure rate of different diameter IMHs following primary sur-gery,and the closure rate,best-corrected visual acuity(BCVA),intraocular pressure(IOP),and complications after the secondary surgery involving the fluid-air exchange of lateral position for persistent macular holes were evaluated.Results The vitrectomy combined with ILM peeling was performed on the 218 eyes of 205 patients diagnosed with IMH.MH closure was achieved in 197 eyes(186 patients)after the first surgery,with closure rates of 90.37%.The closure rates in patients with an IMH diameter<400 μm were 100%,between 400 μm and 800 μm were 91.2%,and>800 μm was only 35.71%.Lateral positioning fluid 14%C3F8 exchange was performed in 18 eyes with persistent macular holes following the initial sur-gery.The average diameter of MH in the 18 eyes was(702±131)μm.The closure rate of macular hole after the first fluid-air exchange was 77.78%(14/18),88.89%(16/18)after the second exchange,and 88.89%(16/18)after the third exchange.The MH of the two patients who underwent three times of fluid-air exchanges was finally closed by extending internal limit-ing membrane peeling and massaging the retina around the MH with flute needle.The preoperative BCVA of 18 eyes was(1.139±0.349)logMAR,which was significantly improved to(0.815±0.356)logMAR at the last follow-up(Z=-2.868,P<0.05).The preoperative IOP was(14.29±2.87)mmHg,and there was no significant difference compared with the IOP of(15±4.29)mmHg at the last follow-up(Z=-0.244,P>0.05).The average follow-up time was(6.05±2.84)months(range 3～16 months).Conclusions Fluid-air exchange in a lateral position is a simple,safe,and effective method for manag-ing persistent MH after primary surgery,and can thus serve as the preferred treatment option in cases of primary surgical failure.关键词
视网膜穿孔/外科学/液气交换/玻璃体视网膜手术Key words
Retinal perforations/Surgery/Fluid-air Change/Vitreoretinal surgery引用本文复制引用
姜涵,朱平凡,吕乐雨,孙晓蕾,张静静,原公强..特发性黄斑裂孔初次手术闭合率及侧卧位液气交换疗效分析[J].临床眼科杂志,2025,33(2):97-100,4.基金项目
国家自然科学基金青年基金(82101164) （82101164）
泰山学者工程专项经费(tsqn202211344) （tsqn202211344）
山东省自然科学基金(ZR2021MH074、ZR2021MH152) （ZR2021MH074、ZR2021MH152）
