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                  [1]柴宛璇,游志鵬,胡寒英,等.玻璃體切割術(PPV)、PPV聯合內界膜剝除以及PPV聯合環中心凹內界膜剝除治療病理性近視黃斑劈裂的療效及安全性的對比分析[J].眼科新進展,2023,43(7):553-557.[doi:10.13389/j.cnki.rao.2023.0111]
                   CHAI Wanxuan,YOU Zhipeng,HU Hanying,et al.Compare of efficacy&safety of pars plana vitrectomy, combined complete internal limiting membrane peeling,&fovea-sparing internal limiting membrane peeling in pathological myopic foveoschisis treat[J].Recent Advances in Ophthalmology,2023,43(7):553-557.[doi:10.13389/j.cnki.rao.2023.0111]
                  點擊復制

                  玻璃體切割術(PPV)、PPV聯合內界膜剝除以及PPV聯合環中心凹內界膜剝除治療病理性近視黃斑劈裂的療效及安全性的對比分析/HTML
                  分享到:

                  《眼科新進展》[ISSN:1003-5141/CN:41-1105/R]

                  卷:
                  43卷
                  期數:
                  2023年7期
                  頁碼:
                  553-557
                  欄目:
                  應用研究
                  出版日期:
                  2023-07-05

                  文章信息/Info

                  Title:
                  Compare of efficacy&safety of pars plana vitrectomy, combined complete internal limiting membrane peeling,&fovea-sparing internal limiting membrane peeling in pathological myopic foveoschisis treat
                  作者:
                  柴宛璇游志鵬胡寒英吳泠瑤談赟玉
                  330006 江西省南昌市,南昌大學附屬眼科醫院
                  Author(s):
                  CHAI WanxuanYOU ZhipengHU HanyingWU LingyaoTAN Yunyu
                  Affiliated Eye Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China
                  關鍵詞:
                  視網膜劈裂近視內界膜玻璃體切割術
                  Keywords:
                  foveoschisis myopia internal limiting membrane pars plana vitrectomy
                  分類號:
                  R774
                  DOI:
                  10.13389/j.cnki.rao.2023.0111
                  文獻標志碼:
                  A
                  摘要:
                  目的 對比分析玻璃體切割術(PPV)、PPV聯合內界膜剝除(CMIP)以及PPV聯合環中心凹內界膜剝除(FSIP)治療病理性近視黃斑劈裂(PMF)的療效及安全性。
                  方法 回顧性研究。選取2021年1月至8月于南昌大學附屬眼科醫院確診并行PPV的PMF患者28例33眼作為研究對象。根據手術中對內界膜的處理,回顧性的將研究對象分為3組,PPV組9例10眼(行PPV);CMIP組10例11眼(行PPV聯合CMIP);FSIP組9例12眼(行PPV聯合FSIP)。術后1個月、3個月、6個月隨訪患者BCVA、眼壓、黃斑中心凹劈裂腔厚度(CFT)、視網膜復位情況,術后不良事件發生率。
                  結果 術后1個月、3個月、6個月3組患者BCVA均較術前顯著改善(均為P<0.001)。術前,術后1個月、3個月、6個月3組患者間BCVA比較差異均無統計學意義(均為P>0.05)。比較3組患者間各時間點平均BCVA(logMAR)與術前BCVA(logMAR)的差值(ΔBCVA),經重復測量方差分析發現,PPV組患者BCVA隨時間變化差異有統計意義(P<0.001)。術后1個月、3個月、6個月3組患者CFT均較術前明顯減。ň鶠P<0.001)。術后1個月、3個月、6個月3組患者間CFT比較差異均無統計學意義(均為P>0.05),各組內不同時間點CFT兩兩比較均差異無統計學意義(均為P>0.05)。末次隨訪時,PPV組患者視網膜完全復位率為60%(6眼),部分復位率40%(4眼),未復位率0%(0眼);CMIP組患者視網膜完全復位率為72.7%(8眼),部分復位率18.2%(2眼),未復位率9.1%(1眼);FSIP組患者視網膜完全復位率為66.7%(8眼),部分復位率25%(3眼),未復位率8.3%(1眼);3組患者視網膜復位情況差異無統計學意義(P>0.05)。隨訪過程中CMIP組及FSIP組術后各出現1眼全層黃斑裂孔。3組患者術中術后未出現眼內炎、玻璃體積血、視網膜脫離等其他并發癥。
                  結論 PPV能有效改善PMF患者視力,不剝除內界膜的術式與兩種剝除內界膜的手術方式對于患者的療效和安全性相當。
                  Abstract:
                  Objective To compare and analyze the efficacy and safety of pars plana vitrectomy (PPV), PPV combined complete internal limiting membrane peeling (CMIP), and PPV combined fovea-sparing internal limiting membrane peeling (FSIP) in the treatment of pathological myopic foveoschisis (PMF).
                  Methods A retrospective study was performed. From January 2021 to August 2021, 28 PMF patients (33 eyes) who received PPV in the Affiliated Eye Hospital of Nanchang University were included. Based on the treatment of the internal limiting membrane during the surgery, the subjects were retrospectively divided into three groups: 9 patients (10 eyes) treated with PPV (PPV group); 10 patients (11 eyes) treated with PPV combined with CMIP (CMIP group); 9 patients (12 eyes) treated with PPV combined with FSIP (FSIP group). Best corrected visual acuity (BCVA), intraocular pressure, central foveoschisis thickness (CFT), retinal reattachment and incidence of postoperative adverse events were measured at 1 month, 3 months, and 6 months after the surgery.
                  Results At 1 month, 3 months, and 6 months after the surgery, the BCVA of patients in the three groups significantly improved compared with that before surgery (all P<0.001). There was no statistically significant difference in BCVA among the three groups before and 1 month, 3 months, and 6 months after surgery (all P>0.05). The difference between the average BCVA (logMAR) and preoperative BCVA (logMAR) among the three groups(Δ BCVA) was compared, and variance analysis of repeated measurements was conducted, demonstrating a statistically significant difference in BCVA at different time points in the PPV group (P<0.001). At 1 month, 3 months, and 6 months after the surgery, the CFT of the three groups significantly decreased compared with that before surgery (all P<0.001); there was no statistically significant difference in the pairwise comparison of CFT at different time points in the three groups (all P>0.05). At the last follow-up, the complete retinal reattachment rate in the PPV group was 60% (6 eyes), the partial reattachment rate was 40% (4 eyes), and the non-reattachment rate was 0% (0 eyes); the complete retinal reattachment rate in the CMIP group was 72.7% (8 eyes), partial reattachment rate was 18.2% (2 eyes), and the non-reattachment rate was 9.1% (1 eye); the complete retinal reattachment rate in the FSIP group was 66.7% (8 eyes), the partial reduction rate was 25% (3 eyes), and the non-reattachment rate was 8.3% (1 eye). There was no statistically significant difference in retinal reattachment among the three groups (P>0.05). During the follow-up, the full-thickness macular hole was found in one eye in the CMIP group and one eye in the FSIP group after surgery. There were no other postoperative complications, such as endophthalmitis, vitreous hemorrhage or retinal detachment in the three groups.
                  Conclusion PPV can effectively improve the vision of PMF patients, and the efficacy and safety of PPV combined with no internal limiting membrane peeling is equivalent to two surgical methods of PPV combined with internal limiting membrane peeling.

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                  備注/Memo

                  備注/Memo:
                  江西省教育廳科學技術研究項目(編號:GJJ210258)
                  更新日期/Last Update: 2023-07-05
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