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目的 为了确定用吲哚青绿介导特发性黄斑裂孔第3、4期视网膜内界膜剥除手术的解剖和视觉效果。方法连续研究3～4期特发性黄斑裂孔病人之8例28只眼。所有眼都施行平部玻璃体次全切除术,必要时清除後部玻璃体及任何可见的视网膜前膜。将浓度为每毫升0.25mg至1.25mg的ICG溶液缓慢地注入到黄斑,待浸渍时停止。内界膜被染色,距黄斑裂孔边缘1～2个视盘直径环行剥除内界膜。手术结束时使用12％Perfluoropropane(C_3F_8)气体。术後病人需要保持面朝下2周。结果 随访时间为6～14个月,平均9.5个月。14只眼(50％)为黄斑裂孔第4期,另14只眼(50％)为黄斑裂孔第3期。11只眼(39.3％)为1年以上的慢性黄斑裂孔。最後随访时25只眼(89.3％)解剖复位,黄斑裂孔闭合。其中21只眼(75％)黄斑裂孔封闭,另4眼(14.3％)黄斑裂孔变平。18只眼(64.3％)视力提高两行或两行以上。视力平均提高2.6行(范围2～7行)。非慢性裂孔和慢性裂孔分别提高3.4行和1.4行。经统计学处理,两组间具有显著性差异(ρ=0.031)。结论 ICG介导视网膜内界膜剥除在封闭特发性黄斑裂孔第3～4期中是很有帮助的。
Objective To determine the anatomical and visual effects of intradermal parietal membrane stripping surgery in stage 3 and 4 of idiopathic macular hole mediated by indocyanine green. Methods Continuous study of 3 to 4 cases of idiopathic macular hole patients in 8 cases 28 eyes. Subtotal vitrectomy was performed in all eyes, with the posterior vitreous and any visible anterior retinal membranes removed if necessary. An ICG solution at a concentration of 0.25 mg to 1.25 mg per ml is slowly injected into the macula and stopped when impregnated. The inner limiting membrane was stained and the inner limiting membrane was stripped from the disc diameter of 1 ~ 2 at the edge of the macular hole. Use 12% Perfluoropropane (C_3F_8) gas at the end of surgery. Postoperative patients need to be kept face down for 2 weeks. Results The follow-up time ranged from 6 to 14 months with an average of 9.5 months. Fourteen eyes (50%) had stage 4 macular holes and the other 14 eyes (50%) had stage 3 macular holes. 11 eyes (39.3%) had chronic macular hole more than one year. At final follow-up, 25 eyes (89.3%) underwent anatomic reduction and macular holes closed. Among them, 21 eyes (75%) had macular holes closed and the other 4 eyes (14.3%) had macular holes flattened. Eighteen eyes (64.3%) improved vision by two or more lines. Visual acuity increased by 2.6 lines (range 2 to 7 lines). Non-chronic and chronic holes increased by 3.4 and 1.4 lines, respectively. Statistically, there was a significant difference between the two groups (ρ = 0.031). Conclusion ICG-mediated endometrial stripping of the retina is helpful in blocking stages 3 to 4 of idiopathic macular holes.