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目的评价特发性全层黄斑裂孔内界膜剥除手术治疗的效果及视功能的预后。方法特发性全层黄斑裂孔31例共35眼,均采用常规玻璃体切割和C3F8填充,同时在不经任何辅助剂染色的情况下使用自制钩针辅助下进行内界膜剥离治疗,术前术后采用OCT及标准对数视力表等对患眼进行检查和随访。结果术后裂孔闭合率达93.7%,视力提高率达91.4%;视物变形等症状也有明显改善。并发症:术中7眼出现毛细血管性出血,术后1d～7d8眼患者出现眼压升高(均<40mmHg),5眼出现后囊下混浊性白内障及老年性白内障进展。结论内界膜剥离可使特发性层黄斑裂孔获得较高的闭合率,视功能亦可得到较好的恢复。
Objective To evaluate the outcome of surgical treatment of idiopathic full thickness macular hole and the prognosis of visual function. Methods Thirty-five cases of idiopathic full-thickness macular hole were treated with conventional vitrectomy and C3F8 filling. At the same time, they were treated with self-made crochet needle assisted with internal limiting membrane dissection without preoperative and postoperative Using OCT and standard logarithmic visual acuity table for the inspection and follow-up. Results The postoperative closed rate of hiatus was 93.7% and the rate of improvement of visual acuity was 91.4%. The symptom such as optic deformity was also significantly improved. Complications: Capillary hemorrhage occurred in 7 eyes during operation. Intraocular pressure (IOL) was increased in all eyes (all <40 mmHg) from 1 day to 7 days postoperatively. The progression of posterior subcapsular turbidity cataract and senile cataract were observed in 5 eyes. Conclusion The dissection of the internal limiting membrane can make macular hole of the idiopathic layer get a higher closure rate, visual function can also get a better recovery.