不同类型近视牵引性黄斑病变玻璃体的治疗效果

摘要

Objective:To investigate therapeutic effect of traction maculopathy vitreous in patients with different types of myopia.Methods:94 patients with MTM were divided into simple macular splitting MRS group (36),non-invasive retinal detachment (FD) group (31) and full-layer MH (MH) group (27) according to the results of preoperative coherence tomography.All groups underwent standard vitrectomy with three fiat parts of the ciliary body.The patients were followed up for 6months.Comparing the proportion and number of improved corrected eyesight,retinal anatomical reduction rate and macular area visual acuity.Results:After the operation,all groups were improved than before-operation,Average eyesight improvement of MRS group were the highest,number and percentage of eyesight improvement were the highest,followed by FD group and MH group,differences of three groups were statistically significant (P ＜ 0.05);retinal anatomical reduction rate of MRS group was the highest,followed by FD group and MH group,differences were statistically significant (P ＜0.05);macular area visual acuity of MRS group was the highest,followed by FD group and MH group,differences were statistically significant(P ＜0.05);macular healing of MRS group was obviously higher than FD and MH group,differences were statistically significant (P ＜ 0.05).Conclusion:The effect of different types of myopia on patients with traumatic macular degeneration was different.MRS stage was the prime time to perform operation.%目的:探究不同类型近视牵引性黄斑病变玻璃体的治疗效果.方法:选取94例近视牵引性黄斑病变玻璃体(MTM)患眼,根据术前相干断层扫描不同类型病变结果,将患眼分为单纯黄斑劈裂(MRS)组36眼、无裂孔性视网膜脱离(FD)组31眼和全层全层黄斑裂孔(MH)组27眼,3组患眼均行标准三道经睫状体平坦部位的玻璃体切除手术,手术后随访6月,比较3组患眼矫正视力改善的数量及比例、视网膜解剖复位率及黄斑区视敏度.结果:手术后,3组患眼与术前比较均有明显改善,MRS组患眼平均视力提高程度最高,视力改善数量及比例最高,FD组次之,MH组最低,3组比较差异具有统计学意义(P＜0.05);视网膜复位率MRS组最高,FD组次之,MH组最低,差异有统计学意义(P＜0.05);黄斑区视敏度MRS组最高,FD组次之,MH组最低,差异具有统计学意义(P ＜0.05);MRS组黄斑愈合比例明显高于FD、MH组,差异有统计学意义(P＜0.05).结论:不同类型近视牵引性黄斑病变患眼行玻璃体切除术的效果不同,病眼病变处于MRS阶段时的手术效果最好.