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Long-Term Anatomic and Functional Outcomes after Macular Hole Surgery

机译:黄斑手术后的长期解剖和功能效果

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摘要

Aim. To evaluate the structural and functional outcomes in patients who underwent macular hole (MH) surgery in the long-term follow-up. Materials and Methods. Forty-four eyes of 40 patients (28 females and 12 males) were examined. The examination included visual acuity, optical coherence tomography, and colour vision testing. The same evaluation was performed in 30 fellow eyes. Results. MH closure was obtained in 42 eyes (95.45%). There was no reopening of the initially closed MHs. In long-term postoperative examination, we observed IS/OS junction defects in 28 (63.6%) eyes and ELM defects in 19 (43.2%) eyes. We found that the IS/OS junction defects correlated with the diameter of the MH (p=0.016), whereas ELM defects correlated with both the diameter of the MH (p=0.001) and duration time of the MH (p=0.008). The presence of ELM defects in OCT was the cause of inferior BCVA in long-term observation time (p=0.004). The mean BCVA before the MH surgery was 0.15. It improved significantly both in early (p<0.001) and long-term postoperative observation (p<0.005). Generally, the functional outcomes were better in eyes with short-time duration of the MH, when a smaller diameter (<400 μm) of the hole was measured and a V-shaped closure of the MH and the restoration of the ELM line on OCT were present. Pseudoprotanomaly was noted in 13 (35.1%) eyes. In the fellow eye group, mean BCVA was 0.95 (range, 0.6–1.0). In 3 eyes, we detected vitreomacular traction, and in 4 eyes, initial cataract. These conditions, as well as probably early stage of diabetes mellitus, influenced functional outcomes of studied eyes. Conclusions. The anatomic and functional outcomes after macular surgery are satisfactory and improve with time. After a successful closing of the MH, the restoration of the retina progresses at a slower pace than improvement in visual acuity.
机译:目的。评估在长期随访中接受黄斑(MH)手术的患者的结构和功能效果。材料和方法。检查了40名患者的四十四只眼睛(28名女性和12名男性)。检查包括视力,光学相干性断层扫描和颜色视觉测试。在30名同伴眼中进行了相同的评价。结果。 MH封闭在42只眼睛(95.45%)。最初封闭的MHS没有重新开放。在长期术后检查中,我们观察到的是28(63.6%)眼睛和ELM缺陷的IS / OS结缺陷19(43.2%)眼睛。我们发现,与MH的直径相关的IS / OS结缺陷(p = 0.016),而ELM缺陷与MH的直径(P = 0.001)和MH的持续时间相关(P = 0.008)。 OCT中的ELM缺陷的存在是长期观察时间(P = 0.004)中的下BCVA的原因。 MH手术前的平均BCVA为0.15。它在早期(P <0.001)和长期术后观察结果显着改善(P <0.005)。通常,在测量孔的较小直径(<400μm)的较小直径(<400μm)和MH的V形闭合和OCT的V形闭合时,功能性结果更好。出现了。在13(35.1%)的眼睛中注意到假障碍胰酸。在同胞组中,平均BCVA为0.95(范围,0.6-1.0)。在3只眼里,我们检测到玻璃体术牵引力,并在4只眼睛,初始白内障。这些条件,以及糖尿病的早期阶段,影响了研究眼睛的功能结果。结论。黄斑手术后的解剖学和功能结果令人满意,随时间而改善。在成功结束MH之后,Retina的恢复以较慢的速度越来越慢于视力的改善。

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