AIM: To compare visual outcomes, central foveal thickness ( CFT), and postoperative complications after vitrectomy and internal limiting membrane ( ILM ) peeling, with balanced salt solution ( BSS ) or gas tamponade, for the treatment of idiopathic macular epiretinal membrane(IMEM).METHODS: Retrospective clinical study. 44 patients with IMEM were included in this study. All patients had undergone vitrectomy and ILM peeling. Eyes were divided into two groups: 20 eyes in group A with BSS tamponade. 24 patients in group B with gas tamponade (11 eyes were injected with filtered air and 13 eyes with perfluoropropane,100mL/L C3F8). The follow-up period was 12-16( mean 13) months. The following parameters were collected and compared: best - corrected visual acuity(BCVA) and CFT (at baseline and 1, 3, 6 and 12 months postoperatively), intraocular pressure(IOP) (at baseline and on the 1th ,7th day, 1, 3 months postoperatively).RESULTS: BCVA significantly improved, and 29 of 44 eyes (65. 9%) achieved visual recovery ≥0. 2 logMAR. There were no significant differences between group A and group B in mean baseline logMAR BCVA (0. 53±0.18 vs 0.52±0.14; P>0.05) and final logMAR BCVA(0.31 ±0.14 vs 0.28±0.09; P>0.05). With respect to OCT parameters, the mean CFT at 12 months (285. 25 ± 70. 07μm) was significantly decreased from that of the baseline (407. 82± 97. 00μm), (Z=4.29, P 0.05) and final CFT (287.60±66. 94μm vs 283.29±73.95μm; P>0. 05). With respect to IOP, there were no significant differences between group A and group B at mean baseline and on the 7th day, 1, 3 months postoperatively (P>0.05). The IOP in group A was significant lower at 1th postoperative day compared with group B (Z=3.12, P0.05).末次随访时A、B组患眼CFT较术前明显降低,从407.82±97.00μm下降到285.25±70.07μm(Z=4.29,P0.05).术后1d,A组眼压(14.25±3.06mmHg)低于B组(17.71±3.20mmHg),差异有统计学意义(Z=3.12,P＜0.05),但两组眼压均值均未超过正常范围(10~21mmHg).术前、术后7d;1,3mo两组间眼压差异均无统计学意义(P>0.05).A组患者术后无需俯卧位,B组患者填充滤过空气者术后俯卧位1~3d,填充100mL/L C3F8者俯卧位至少7d.结论:玻璃体切割联合视网膜内界膜剥离手术治疗特发性黄斑前膜手术末填充BSS或气体均能显著提高视力、降低黄斑中心凹厚度,两者的临床疗效无显著差异,但填充BSS可避免术后俯卧位,减轻患者术后身体及精神负担,同时手术更加快捷、安全.
展开▼
