摘要
Abstract
Objective To observe the efficacy of vitrectomy combined with autologous blood coverage in the treatment of patients with high myopia macular hole retinal detachment.Methods This was a retrospective case-control study.A total of 58 patients(58 eyes)with high myopia macular hiatus retinal detachment who were examined and admitted to Xuzhou First People's Hospital from January 1,2020 to May 1,2025 were included in the study.Both affected eyes un-derwent 25 G vitrectomy and silicone oil tamponade.The affected eyes were divided into the study group and the control group according to different surgical methods,with 29 cases(28 eyes)in the study group undergoing vitrectomy with autolo-gous blood coverage,and 30 cases(30 eyes)in the control group undergoing vitrectomy combined with internal limiting membrane detachment.The follow-up time after the surgery was 3～12 months,with an average follow-up time of 8 months.The macular hole closure rate,retinal reduction rate and postoperative best corrected visual acuity(BCVA)were observed in the two groups.Results At the end of follow-up,27 eyes(96％)had primary retinal reduction in the study group and 27 eyes(90％)in the control group.During the follow-up period,48 eyes(83％)had macular hole closure,and the 26 eyes(93％)in the study group had more macular hole closure than 17 eyes(57％)in the control group,and the difference was statistically significant(x2=9.893,P=0.002).The postoperative BCVA(1.91±0.66)logMAR was higher than that of the pre-operative BCVA(2.33±0.73)logMAR between the two groups(F=15.991,P＜0.001).The preoperative BCVA(2.34±0.69)logMAR in the study group and the preoperative BCVA in the control group were(2.32±0.78)logMAR,and the difference was not statistically significant(t=-0.064.P=0.949).The postoperative BCVA of the study group was(1.74±0.56)and log-MAR was higher than that of the control group(2.06±0.71)logMAR,and the difference tended to be statistically significant(t=1.944,P=0.057).The continuous recovery of external limiting membrane(ELM)in the control group in 3 eyes(10％)was lower than that of 9 eyes in the study group(68％),and the difference was statistically significant(x2=4.327,P=0.038).There was no significant difference between postoperative BCVA(1.89±0.60)logMAR in the macular hole closure group and(1.96±0.82)logMAR in the non-macular hole closure group(t=0.3 19,P=0.753).Conclusions Compared with simple internal limiting membrane exfoliation,the postoperative macular hole closure rate,retinal reduction rate and postoperative visual function recovery are significantly improved,and the early recovery of ELM continuity may have a suggestive effect on postoperative BCVA recovery.关键词
高度近视/黄斑裂孔性视网膜脱离/玻璃体切除术/内界膜剥除/内界膜翻转/自体血覆盖Key words
High myopia/Macular hole retinal detachment/Vitrectomy/Internal limiting membrane peeling/Inter-nal limiting membrane flap/Autologous blood coverage
