摘要
目的:探讨玻璃体切割术联合内界膜(ILM)剥除对累及黄斑的孔源性视网膜脱离(RRD)患者的治疗效果及对黄斑前膜(ERM)形成的影响。方法:选取2016年10月-2021年9月在常州市第三人民医院接受手术治疗的40例累及黄斑的RRD患者作为研究对象,按照随机数字表法分为对照组和观察组,各20例。对照组采用玻璃体切割术进行治疗,观察组采用玻璃体切割术联合ILM剥除进行治疗,比较两组ERM形成情况、最佳矫正视力(BCVA)、视网膜复位情况、黄斑水肿发生情况、椭圆体带完整情况。结果:手术后6个月,两组ERM形成率比较,差异无统计学意义(P>0.05);手术后12个月,观察组ERM形成率低于对照组,差异有统计学意义(P<0.05)。手术前,两组BCVA比较,差异无统计学意义(P>0.05);手术后1个月、6个月、12个月,观察组BCVA低于对照组,差异有统计学意义(P<0.05)。观察组手术后12个月视网膜复位率、椭圆体带完整率高于对照组,黄斑水肿发生率低于对照组,差异有统计学意义(P<0.05)。结论:对累及黄斑的RRD患者实施玻璃体切割术联合ILM剥除,能有效预防ERM的形成,提高视网膜复位率,改善患者视力,降低黄斑水肿等并发症发生风险,建议临床应用并予以推广。
Objective:To investigate the effect of vitrectomy combined with internal limiting membrane(ILM)peeling in treatment of patients with rhegmatogenous retinal detachment(RRD)involving macula and its influence on the formation of epiretinal membrane(ERM).Methods:From October 2016 to September 2021,40 RRD patients with macular involvement who underwent surgical treatment in the Changzhou Third People’s Hospital were selected as the study subjects,and they were divided into control group and observation group according to the random number table method,with 20 cases in each group.The control group was treated by vitrectomy,and the observation group was treated by vitrectomy combined with ILM peeling.The ERM formation,best-corrected visual acuity(BCVA),retinal reattachment,macular edema occurrence,and ellipsoidal band integrity were compared between the two groups.Results:At 6 months after surgery,there was no significant difference in ERM formation rate between the two groups(P>0.05).At 12 months after surgery,the ERM formation rate in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference in BCVA between the two groups(P>0.05).At 1 month,6 months and 12 months after surgery,the BCVA in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).At 12 months after surgery,the retinal reattachment rate and ellipsoidal band integrity rate in the observation group were higher than those in the control group,and the incidence of macular edema in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Vitrectomy combined with ILM peeling for RRD patients with macular involvement can effectively prevent the formation of ERM,improve retinal reattachment rate,improve the visual acuity,reduce the occurrence risk of complications such as macular edema.It’s recommended for clinical application and promotion.
作者
周吉林
Zhou Ji-lin(Department of Ophthalmology,Changzhou Third People's Hospital,Changzhou 213000,Jiangsu Province,China)
出处
《中国社区医师》
2022年第33期70-72,共3页
Chinese Community Doctors
关键词
孔源性视网膜脱离
玻璃体切割术
内界膜剥除
黄斑前膜
Rhegmatogenous retinal detachment
Vitrectomy
Internal limiting membrane peeling
Epiretinal membrane
