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目的 观察单纯玻璃体切割、玻璃体切割联合血小板封孔、玻璃体切割联合黄斑区内界膜剥除、玻璃体切割联合血小板封孔及黄斑区内界膜剥除 4种手术方法治疗老年性特发性黄斑裂孔的疗效。 方法 回顾分析 ～ 期老年性特发性黄斑裂孔患者 86只患眼的手术疗效。以上述 4种手术方式分组的患眼数分别为 7、4 0、14、2 5只眼 ,手术后随诊 3～ 5 5个月 ,以手术后裂孔闭合、视力改变及手术并发症等作为疗效观察的指标。裂孔闭合判定标准为在检眼镜和 (或 )光相干断层成像术 (optic coherence tomography,OCT)检查时不能分辨黄斑裂孔缘。远、近视力提高 2行以上者计为视力改善。 结果 玻璃体切割联合血小板封孔组视力改善者占 80 .0 % ,优于其它 3种治疗方法 (P<0 .0 5 ) ;单纯玻璃体切割组裂孔闭合率最低 ,占 4 2 .9% ,与玻璃体切割联合血小板封孔组的裂孔闭合率 (87.5 % )、玻璃体切割联合血小板封孔及黄斑区内界膜剥除组的裂孔闭合率 (92 .0 % )比较差异有显著性意义 (P<0 .0 5 ) ;视物变形改善、手术并发症等情况 4组比较差异无显著性意义。 结论 玻璃体切割联合血小板封孔有助于老年性特发性黄斑裂孔患者手术后黄斑裂孔闭合及视力恢复 ;手术中使用黄斑区内界膜剥除技术可提高黄斑裂孔的解剖复位率 ,但
Objective To observe the effects of vitrectomy combined with vitrectomy combined with platelet sealing, vitrectomy combined with intramembrane dissection in vitreous, vitrectomy combined with platelet sealing and intramembrane demarcation in macula in the treatment of senile idiopathic macular hole Efficacy. Methods A retrospective analysis of 86 elderly patients with idiopathic macular hole with eye surgery. The number of eyes grouped by the above four kinds of operation was 7,4 0,14,25 eyes respectively. The patients were followed up for 3 to 55 months. The postoperative closed eyes, visual acuity and surgical complications Efficacy indicators. Holes closure criteria are defined as the inability to distinguish the macular hole margin during ophthalmoscopy and / or OCT. Far, near vision improvement of more than 2 lines as visual acuity improved. Results Compared with the other three treatments (80%), the visual acuity of vitrectomy combined with platelet sealing group was significantly better than that of the other three methods (P <0.05). The rate of hilar closure in vitrectomy group was the lowest (42.2%), There were significant differences between the vitrectomy combined with platelet sealing group (87.5%), the vitrectomy combined with platelet sealing and the macular hole membrane debridement group (92.0%) (P < 0 .0 5); visual material deformation improvement, surgical complications and other 4 groups showed no significant difference. Conclusions Vitrectomy combined with platelet sealing is helpful for the treatment of macular hole closure and visual acuity after operation in patients with senile idiopathic macular hole. The macular delamination technique can improve the anatomic reduction rate of macular hole,