Abstract：
OBJECTIVE: To report the comparison of the therapeutic effects of lens capsular flap transplantation (LCT) and autologous retinal transplantation (ART) in refractory macular hole (MH) treatment.
METHODS: Thirty-one patients (31 eyes) with refractory MH were retrospectively reviewed. The patients were divided into two groups based on the surgical procedures: the LCT group (13 eyes) and the ART group (18 eyes). Patients were monitored for a minimum of 6 months. Best corrected visual acuity (BCVA), hole closure rate, postoperative central foveolar thickness (CFT), and some complications (e.g. graft loss or dislocation, postoperative retinal detachment, or postoperatively elevated intraocular pressure) were the primary outcome measures.
RESULTS: The mean preoperative MH diameter was 1104 ± 287 μm in the LCT group and 1066 ± 297 μm in the ART group (t = 0.353, P = 0.727). The MH was closed in 12 patients (92.3%) of the LCT group and 17 patients (94.4%) of the ART group (χ2 = 0.057, P = 0.811); the MHs of 10 patients (76.9%) in the LCT group and 11 patients (61.1%) in the ART group were completely closed (χ2 = 0.864, P = 0.353). The BCVA improved from 2.3 ± 1.0 logMAR preoperatively to 1.3 ± 0.9 logMAR postoperatively in the LCT group and 2.3 ± 0.9 logMAR preoperatively to 1.0 ± 0.6 logMAR postoperatively in the ART group (postoperative BCVA vs preoperative BCVA in the LCT group: t = 4.374, P = 0.001; postoperative BCVA vs preoperative BCVA in the ART group: t = 5.899, P = 0.000018). The visual improvement was 1.3 ± 0.9 logMAR in the ART group and 1.0 ± 0.8 logMAR in the LCT group (t = - 1.033, P = 0.310). The postoperative CFT was 139.7 ± 48.3 μm in the LCT and 199.2 ± 25.1 μm in the ART group (t = - 4.062, P = 0.001). Graft dislocation emerged in 2 patients (15.4%) in the LCT group and 1 patient (5.6%) in the ART group.
CONCLUSIONS: Applications of LCT and ART may both enhance anatomical and visual outcomes in refractory MH cases. The ART group exhibited a more optimal postoperative CFT than the LCT group one.
METHODS: Thirty-one patients (31 eyes) with refractory MH were retrospectively reviewed. The patients were divided into two groups based on the surgical procedures: the LCT group (13 eyes) and the ART group (18 eyes). Patients were monitored for a minimum of 6 months. Best corrected visual acuity (BCVA), hole closure rate, postoperative central foveolar thickness (CFT), and some complications (e.g. graft loss or dislocation, postoperative retinal detachment, or postoperatively elevated intraocular pressure) were the primary outcome measures.
RESULTS: The mean preoperative MH diameter was 1104 ± 287 μm in the LCT group and 1066 ± 297 μm in the ART group (t = 0.353, P = 0.727). The MH was closed in 12 patients (92.3%) of the LCT group and 17 patients (94.4%) of the ART group (χ2 = 0.057, P = 0.811); the MHs of 10 patients (76.9%) in the LCT group and 11 patients (61.1%) in the ART group were completely closed (χ2 = 0.864, P = 0.353). The BCVA improved from 2.3 ± 1.0 logMAR preoperatively to 1.3 ± 0.9 logMAR postoperatively in the LCT group and 2.3 ± 0.9 logMAR preoperatively to 1.0 ± 0.6 logMAR postoperatively in the ART group (postoperative BCVA vs preoperative BCVA in the LCT group: t = 4.374, P = 0.001; postoperative BCVA vs preoperative BCVA in the ART group: t = 5.899, P = 0.000018). The visual improvement was 1.3 ± 0.9 logMAR in the ART group and 1.0 ± 0.8 logMAR in the LCT group (t = - 1.033, P = 0.310). The postoperative CFT was 139.7 ± 48.3 μm in the LCT and 199.2 ± 25.1 μm in the ART group (t = - 4.062, P = 0.001). Graft dislocation emerged in 2 patients (15.4%) in the LCT group and 1 patient (5.6%) in the ART group.
CONCLUSIONS: Applications of LCT and ART may both enhance anatomical and visual outcomes in refractory MH cases. The ART group exhibited a more optimal postoperative CFT than the LCT group one.
摘要：
目的：报道晶状体囊瓣移植(LCT)与自体视网膜移植(ART)治疗难治性黄斑裂孔(MH)的疗效比较。
方法：对31例(31只眼)难治性MH患者进行回顾性分析。根据手术方式将患者分为两组：LCT组（13只眼）和ART组（18只眼）。对患者进行至少6个月的监测。最佳矫正视力（BCVA），孔闭合率,术后中央凹窝厚度（CFT），和一些并发症（例如移植物丢失或脱位，术后视网膜脱离,或术后眼压升高）是主要结局指标。
结果：术前平均MH直径LCT组为1104±287μm，ART组为1066±297μm（t=0.353，P=0.727）。LCT组12例(92.3%)、ART组17例(94.4%)MH闭合(χ2=0.057,P=0.811);LCT组10例(76.9%)、ART组11例(61.1%)MH完全闭合(χ2=0.864,P=0.353)。LCT组术前的BCVA从术前的2.3±1.0logMAR提高到术后的1.3±0.9logMAR，ART组术前的2.3±0.9logMAR提高到术后的1.0±0.6logMAR（LCT组术后BCVA与术前BCVA：t=4.374，P=0.001；ART组术后BCVA与术前BCVA：t=5.899，P=0.000018）ART组视力改善为1.3±0.9logMAR,LCT组为1.0±0.8logMAR(t=-1.033,P=0.310)。LCT组术后CFT为139.7±48.3μm,ART组为199.2±25.1μm(t=-4.062,P=0.001)。LCT组2例(15.4%)和ART组1例(5.6%)出现移植物脱位。
结论：LCT和ART的应用可以增强难治性MH病例的解剖和视觉结果。ART组比LCT组表现出更好的术后CFT。
方法：对31例(31只眼)难治性MH患者进行回顾性分析。根据手术方式将患者分为两组：LCT组（13只眼）和ART组（18只眼）。对患者进行至少6个月的监测。最佳矫正视力（BCVA），孔闭合率,术后中央凹窝厚度（CFT），和一些并发症（例如移植物丢失或脱位，术后视网膜脱离,或术后眼压升高）是主要结局指标。
结果：术前平均MH直径LCT组为1104±287μm，ART组为1066±297μm（t=0.353，P=0.727）。LCT组12例(92.3%)、ART组17例(94.4%)MH闭合(χ2=0.057,P=0.811);LCT组10例(76.9%)、ART组11例(61.1%)MH完全闭合(χ2=0.864,P=0.353)。LCT组术前的BCVA从术前的2.3±1.0logMAR提高到术后的1.3±0.9logMAR，ART组术前的2.3±0.9logMAR提高到术后的1.0±0.6logMAR（LCT组术后BCVA与术前BCVA：t=4.374，P=0.001；ART组术后BCVA与术前BCVA：t=5.899，P=0.000018）ART组视力改善为1.3±0.9logMAR,LCT组为1.0±0.8logMAR(t=-1.033,P=0.310)。LCT组术后CFT为139.7±48.3μm,ART组为199.2±25.1μm(t=-4.062,P=0.001)。LCT组2例(15.4%)和ART组1例(5.6%)出现移植物脱位。
结论：LCT和ART的应用可以增强难治性MH病例的解剖和视觉结果。ART组比LCT组表现出更好的术后CFT。
