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                  [1]石蓮軍,張蘇,徐向忠,等.鞏膜外黃斑外墊壓術治療硅油填充術后復發性超高度近視黃斑裂孔性視網膜脫離[J].眼科新進展,2019,39(3):267-269.[doi:10.13389/j.cnki.rao.2019.0060]
                   SHI Lian-Jun,ZHANG Su,XU Xiang-Zhong,et al.Macular scleral buckle for recurrent macular hole retinal detachment after vitrectomy with silicone oil tamponade in ultra-high myopia eyes[J].Recent Advances in Ophthalmology,2019,39(3):267-269.[doi:10.13389/j.cnki.rao.2019.0060]
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                  鞏膜外黃斑外墊壓術治療硅油填充術后復發性超高度近視黃斑裂孔性視網膜脫離/HTML
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                  《眼科新進展》[ISSN:1003-5141/CN:41-1105/R]

                  卷:
                  39卷
                  期數:
                  2019年3期
                  頁碼:
                  267-269
                  欄目:
                  應用研究
                  出版日期:
                  2019-03-05

                  文章信息/Info

                  Title:
                  Macular scleral buckle for recurrent macular hole retinal detachment after vitrectomy with silicone oil tamponade in ultra-high myopia eyes
                  作者:
                  石蓮軍張蘇徐向忠姚進沈軼
                  210000 江蘇省南京市,南京醫科大學眼科醫院
                  Author(s):
                  SHI Lian-JunZHANG SuXU Xiang-ZhongYAO JinSHEN Yi
                  Affiliated Eye Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu Province,China
                  關鍵詞:
                  超高度近視復發性超高度近視黃斑裂孔性視網膜脫離黃斑外墊壓術MEDPOR種植體
                  Keywords:
                  ultra-high myopiarecurrent MHRDmacular scleral buckleMEDPOR implant
                  分類號:
                  R778.1
                  DOI:
                  10.13389/j.cnki.rao.2019.0060
                  文獻標志碼:
                  A
                  摘要:
                  目的 探討鞏膜外黃斑外墊壓術治療硅油填充術后復發性超高度近視黃斑裂孔性視網膜脫離(macular hole retinal detachment,MHRD) 的可行性及療效。方法 回顧性分析 2016年6月至2018年1月玻璃體切割硅油填充術后的復發性超高度近視MHRD患者10例(10眼),所有患者均由同一術者行鞏膜外黃斑外墊壓術,將MEDPOR種植體+人造血管+環扎條帶制成的“三明治加壓塊”固定墊壓于黃斑區,術后行眼眶CT檢查明確加壓塊位置。術后6~12個月取出硅油。術后隨訪18個月,觀察并記錄術后并發癥、視網膜脫離復位、黃斑裂孔閉合情況、術后視力、眼軸長度等指標。結果 眼眶CT顯示10眼加壓塊均位于黃斑區;末次隨訪 SD-OCT示10眼視網膜完全復位,7眼黃斑裂孔完全閉合,3眼黃斑裂孔部分閉合;9眼術后最佳矯正視力(best corrected visual acuity,BCVA)較術前提高,1眼提高不明顯;術前患者 BCVA為(1.55±0.26)LogMAR,術后3個月BCVA為(0.99±0.05)LogMAR,與術前比較差異有統計學意義(P<0.001);術前患者眼軸長度為(31.27±1.18)mm,術后3個月為(28.81±0.87)mm,與術前比較差異有統計學意義(P<0.001)。所有患眼均未發生眼底出血、眼內炎、渦靜脈回流障礙、眼前部缺血綜合征等并發癥。結論 鞏膜外黃斑外墊壓術是治療硅油填充術后復發性超高度近視MHRD安全有效的手術方法,能提高視網膜解剖復位率、黃斑裂孔閉合率和視力。
                  Abstract:
                  Objective To evaluate the feasibility and efficacy of macular ablation in the treatment of recurrent macular hole retinal detachment (MHRD) in ultra-high myopia after vitrectomy with silicone oil tamponade.Methods Ten patients (10 eyes) with recurrent ultra-high myopia MHRD after vitrectomy combined with silicone oil tamponade from June 2016 to January 2018 were enrolled and the clinical data were retrospectively analyzed.All patients were treated with macular buckle using a “sandwich structure compression block” made of MEDPOR implant+artificial blood vessels+entangled strip which operated by the same surgeon.The position of the pressure block was examined by orbital CT after operation.The patients were followed up for 18 months,and silicone oil was eliminated after 6-12 months.Postoperative complications,retinal detachment,macular hole closure,postoperative visual acuity,axial length and other indicators were observed and recorded.Results Orbital CT showed that 10 blocks were all in the macular area;the last follow-up SD-OCT showed complete retinal reattachment achieved in all 10 eyes,including macular hole completely closed in 7 eyes and partially closed in 3 eyes;finally,9 eyes had the best corrected visual acuity (BCVA) improved and the improvement was not obvious in one eye;the average preoperative BCVA was (1.55±0.26)LogMAR and (0.99±0.05)LogMAR at 3 months postoperatively,and the difference was statistically significant (P<0.001);the average axial length of the patients before surgery was (31.27±1.18)mm and the postoperative 3 months was (28.81±0.87)mm,and the difference was statistically significant (P<0.001).There was no complication such as fundus hemorrhage,endophthalmitis,vortex venous reflux disorder,anterior ischemic syndrome in all eyes.Conclusion Macular scleral buckle is a safe and effective surgical method for the treatment of recurrent ultra-high myopia MHRD after vitrectomy with silicone oil tamponade.It may improve the rate of retinal reattachment,macular hole closure and visual acuity.

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                  更新日期/Last Update: 2019-03-15
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