Multicenter, retrospective clinical cohort study.
Consecutive eyes that underwent vitrectomy for advanced MTM with tamponade of air, sulfur hexafluoride (SF6), or perfluoropropane (C3F8) or without tamponade with a minimum follow-up of 12 months were included. Main outcome measures included postoperative visual acuity (VA) at 12 months in eyes with vs without tamponade.
We included a total of 193 eyes (193 patients) in this study; 136 eyes (70%) treated with tamponade were compared with 57 eyes (30%) treated without tamponade. Baseline characteristics did not differ significantly between the groups. Both groups showed significant visual improvement at 12 months (both P < .001). However, postoperative visual acuity and visual improvement at 12 months were significantly better (P = .003 and P = .028, respectively) in eyes without tamponade, although the MTM in these eyes without tamponade took longer to resolve (P = .039). Retinal thickness and the ellipsoid zone were more preserved in eyes without tamponade (P < .001 and P = .001, respectively). Complications such as macular holes did not differ between the groups. A novel imaging finding of \"schisis bending (accordioning)\" was identified during MTM resolution.
Vitrectomy either with or without tamponade for MTM was effective in improving vision in this study. However, eyes without tamponade experienced even better visual improvement and preserved retinal anatomy, despite a longer schisis resolution time. Surgery without tamponade may achieve better visual outcomes.
方法:多中心,回顾性临床队列研究。
方法:连续眼睛接受玻璃体切除术治疗晚期MTM并填充空气,六氟化硫(SF6),或全氟丙烷(C3F8)或无填塞,最少随访12个月。主要结果指标包括有与无填塞的眼睛在12个月时的术后视力(VA)。
结果:在这项研究中,我们共纳入193只眼(193名患者);使用填塞治疗的136只眼(70%)与未使用填塞治疗的57只眼(30%)进行比较。两组之间的基线特征没有显着差异。两组在12个月时视力均有显著改善(均P<.001)。然而,术后视力和视力改善在12个月显著更好(P=.003和P=.028,分别)的眼睛没有填塞,尽管这些眼睛中的MTM没有填塞需要更长的时间才能解决(P=0.039)。在没有填塞的情况下,视网膜厚度和椭圆体区更多地保留(分别为P<.001和P=.001)。两组之间的黄斑裂孔等并发症没有差异。在MTM分辨率期间,发现了“分裂弯曲(手风琴)”的新成像发现。
结论:在这项研究中,有或没有填充MTM的玻璃体切除术可有效改善视力。然而,没有填塞的眼睛经历了更好的视觉改善和保留的视网膜解剖,尽管schisis解决时间更长。没有填塞的手术可以获得更好的视觉结果。