Vitrectomy

玻璃体切除术
  • 文章类型: Journal Article
    目的:本研究旨在调查人口统计学,临床特征,急性感染性眼内炎(AIE)患者的治疗结果。
    方法:对2017年至2022年临床诊断为感染性眼内炎的所有患者进行回顾性分析。人口统计数据,患者的临床特征,急性感染性眼内炎的类型(术后,创伤后,气泡相关,和内源性眼内炎),手术后病例的外科手术类型,玻璃体样品的微生物分析结果,治疗措施,并记录患者的视觉结果。
    结果:在这项研究中,182名与会者包括122名男性(67%)和60名女性(33%),参与其中。患者平均年龄为54.56±21岁,年龄在1-88岁之间。最常见的AIE类型是术后(59.9%),其次是内源性(19.2%),创伤后(17%),和泡相关(3.8%)。AIE患者术后亚组中最常见的眼内手术类型是超声乳化术(57.8%)。患者的主要和最终BCVA的中位数(四分位距)为1.5(1.35,1.85)和0.65(0.35,1.35),分别。玻璃体混浊等级(OR,2.89;95%CI,1.11-5.74;p=0.009)和主要VA(OR,60.34;95%CI,2.87-126.8;p=0.008)显示最终视力丧失的统计学意义。
    结论:AIE是一种破坏性疾病,视力不良,无论其类型如何,都具有急性炎症体征和症状。然而,及时和适当的治疗导致许多患者的视力恢复到功能水平。
    OBJECTIVE: This study aimed to investigate the demographics, clinical characteristics, and management outcomes of patients with acute infectious endophthalmitis (AIE).
    METHODS: This retrospective chart review was conducted on all patients admitted with the clinical diagnosis of infectious endophthalmitis from 2017 to 2022. Demographic data, patients\' clinical characteristics, the type of acute infectious endophthalmitis (post-operative, post-traumatic, bleb-associated, and endogenous endophthalmitis), the type of surgical procedure in the post-operative cases, the microbiologic analysis results of vitreous samples, therapeutic measures, and visual outcomes of patients were recorded.
    RESULTS: In this study, 182 participants, including 122 male (67%) and 60 (33%) female, were involved. The mean age of patients was 54.56 ± 21 years, with a range of 1-88 years old. The most prevalent type of AIE was post-operative (59.9%), followed by endogenous (19.2%), post-traumatic (17%), and bleb-associated (3.8%). The most common type of intraocular surgery in the post-operative subgroups of AIE patients was phacoemulsification (57.8%). The median (interquartile range) of the primary and final BCVA of patients was 1.5 (1.35, 1.85) and 0.65 (0.35, 1.35), respectively. Vitreous haziness grade (OR, 2.89; 95% CI, 1.11-5.74; p = 0.009) and the primary VA (OR, 60.34; 95% CI, 2.87-126.8; p = 0.008) revealed statistical significance for final vision loss.
    CONCLUSIONS: AIE is a devastating condition with poor visual outcomes, which presents with acute inflammatory signs and symptoms regardless of its type. However, prompt and appropriate treatment leads to visual recovery to a functional level in many patients.
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  • 文章类型: Letter
    目的:报告在其他替代方法不适用的情况下,使用自体Tenon补片移植治疗巨大的全厚度黄斑裂孔(FTMHs)的结果。
    方法:对3例病例均采用相同的手术方法。简而言之,收集了Tenon组织的小碎片。通过23G套管针引入移植物,并在PFCL气泡下在黄斑孔上释放。将补片巧妙地推向孔的边缘,以在下面滑动。然后在视盘旁边主动抽吸PFCL气泡。随后注入气体或硅油填充剂,注意在手术过程中尽量减少流体湍流。
    结果:报告了三种巨大FTMHs中自体Tenon贴片移植的结果。在第一种情况下,硅油填塞被注射,在第二个,注入C2F6气体。在第三种情况下,患有晚期青光眼的女性,眼睛里没有留下填塞.在手术期间或之后没有观察到不良反应。在所有三例病例的随访期间,记录了黄斑裂孔的闭合和功能改善。
    结论:经过长达6个月的随访,Tenon补片移植似乎是处理复杂FTMH病例的一种有前途的技术。需要进行其他研究以调查长期结果并确定最合适的适应症。
    OBJECTIVE: To report the results of using autologous Tenon patch grafts for managing giant full-thickness macular holes (FTMHs) when other alternatives are not applicable.
    METHODS: The same surgical technique was performed in all three cases. Briefly, a small fragment of Tenon\'s tissue was collected. The graft was introduced through a 23G trocar and released over the macular hole under a bubble of PFCL. The patch is delicately pushed towards the edges of the hole to slide underneath. The PFCL bubble is then actively aspirated next to the optic disc. Tamponade with gas or silicone oil is subsequently injected, with care taken to minimize fluid turbulence during the procedure.
    RESULTS: The outcomes of autologous Tenon patch grafts in three giant FTMHs are reported. In the first case, silicone oil tamponade was injected, in the second, C2F6 gas was injected. And in the third case, that of a woman with advanced glaucoma, no tamponade was left in the eye. No adverse effects were observed during or after the procedures. Closure of the macular hole and functional improvement were documented during the follow-up period in all three cases.
    CONCLUSIONS: With a follow-up of up to 6 months, the Tenon patch graft appeared to be a promising technique for managing complex cases of FTMH. Additional studies to investigate long-term outcomes and determine the most appropriate indications are warranted.
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  • 文章类型: Journal Article
    背景:磁性眼内异物可以用磁化一次性镊子去除。这项研究的目的是比较不同尺寸的镊子的磁化能力,形式和制造商。
    方法:使用既定程序磁化镊子。在镊子的尖端测量可诱导的磁通量密度。然后在BSS溶液中使用钢球测试可以用磁化镊子提起的质量。测量镊子的金属部分的重量。
    结果:可以感应的磁通量密度,可以提升的钢球的重量和镊子中使用的不锈钢的质量如下:Alcon末端抓取23G:7.12mT,87.43毫克,1191毫克;Alcon端抓25G:6.43mT,87.43毫克,1189毫克;Alcon锯齿状:4.39mT,63.78毫克,1284毫克;Alcon锯齿状23G:3.62mT,13.74毫克,1200毫克;Alcon锯齿状25G:2.4mT,13.74毫克,1195毫克;DORC端抓23G:5.52mT,32.54毫克,153毫克;协同作用端抓23G:4.35mT,16.37毫克,193毫克;VitreqBV末端抓取23G:2.65mT,无,88mg。
    结论:一次性微镊子的可磁化性似乎取决于镊子尖端的钢质量。铁晶格的结构可能具有更大的影响。并非每个一次性镊子都可以被充分磁化以用于该技术。
    BACKGROUND: Magnetic intraocular foreign bodies can be removed with magnetized disposable forceps. Aim of this study is to compare the forceps magnetizability of different size, form and manufacturer.
    METHODS: The forceps were magnetized using an established procedure. The inducible magnetic flux density was measured at the tip of the forceps. The mass that can be lifted with the magnetized forceps was then tested using steel balls in BSS solution. The weight of the metal parts of the forceps was measured.
    RESULTS: The magnetic flux density that could be induced, the weight of the steel balls that could be lifted and the mass of stainless steel used in the forceps were as follows: Alcon end-grasping 23G: 7.12 mT, 87.43 mg, 1191 mg; Alcon end-grasping 25G: 6.43 mT, 87.43 mg, 1189 mg; Alcon serrated: 4.39 mT, 63.78 mg, 1284 mg; Alcon serrated 23G: 3.62 mT, 13.74 mg, 1200 mg; Alcon serrated 25G: 2.4 mT, 13.74 mg, 1195 mg; DORC end-grasping 23G: 5.52 mT, 32.54 mg, 153 mg; Synergetics end-grasping 23G: 4.35 mT, 16.37 mg, 193 mg; Vitreq BV end-grasping 23G: 2.65 mT, none, 88 mg.
    CONCLUSIONS: The magnetizability of a disposable microforceps seems to depend on the mass of steel at the tip of the forceps. The structure of the iron lattice could have an even greater influence. Not every disposable forceps can be sufficiently magnetized for this technique.
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  • 文章类型: Journal Article
    目的:这篇综述旨在总结当前有关临床特征的知识,诊断工作,葡萄膜视网膜前膜(ERM)的治疗方法。
    方法:使用PubMed数据库对文献进行了全面调查。此外,在GoogleScholar上进行了补充搜索,以确保在集合中包含所有相关项目。
    结果:ERM是玻璃体视网膜界面的异常层,由于肌纤维母细胞沿着中央视网膜的内表面增殖,导致视力障碍。以各种名字闻名,ERM有不同的原因,包括特发性或继发性因素,与眼科成像技术,如OCT改善检测。在葡萄膜炎中,ERM的发生很常见,手术干预涉及带ERM剥离的平坦部玻璃体切除术,尽管关于最佳方法的争论仍然存在。
    结论:组织病理学研究和OCT进展改善了ERM的理解,在没有统一模型的情况下揭示一组不同的疾病。共识支持渐进性病例中葡萄膜ERM的手术,但是变异性需要仔细考虑和有效的炎症管理。OCT生物标志物,深度学习,手术的进展可能会提高结果,医疗干预和机器人技术显示出早期ERM干预的希望。
    OBJECTIVE: This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up, and therapeutic approach of uveitic epiretinal membranes (ERM).
    METHODS: A thorough investigation of the literature was conducted using the PubMed database. Additionally, a complementary search was carried out on Google Scholar to ensure the inclusion of all relevant items in the collection.
    RESULTS: ERM is an abnormal layer at the vitreoretinal interface, resulting from myofibroblastic cell proliferation along the inner surface of the central retina, causing visual impairment. Known by various names, ERM has diverse causes, including idiopathic or secondary factors, with ophthalmic imaging techniques like OCT improving detection. In uveitis, ERM occurrence is common, and surgical intervention involves pars plana vitrectomy with ERM peeling, although debates persist on optimal approaches.
    CONCLUSIONS: Histopathological studies and OCT advancements improved ERM understanding, revealing a diverse group of diseases without a unified model. Consensus supports surgery for uveitic ERM in progressive cases, but variability requires careful consideration and effective inflammation management. OCT biomarkers, deep learning, and surgical advances may enhance outcomes, and medical interventions and robotics show promise for early ERM intervention.
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  • 文章类型: Case Reports
    在高度近视的双侧白内障患者中,涉及罕见的原型后房型有晶状体IOL(PC-pIOL)的病例。
    一位64岁的男性出现在我们的诊所,双眼视力不佳。临床检查显示双侧成熟白内障,35年前为解决他的高度近视而植入的牙周病以及PC-pIOL。右眼的视敏度(VA)为20/200,左眼无光感知。计划在右眼进行PC-pIOL提取以及23G平面玻璃体切除术(PPV)和碎裂手术。左眼保守治疗。成功地进行PC-pIOL的提取,同时易于除去。这是一个领结形的晶状体,中间有一个领口状的纽扣,通过瞳孔向前延伸到前房。具有晶状体碎裂的PPV是成功的,并且为了避免放置零屈光度IOL,患者被留下无晶状体。最终最佳校正的VA是手术后一个月的20/25。
    在获得优异的VA的同时没有困难地进行这种罕见的pIOL的去除。在这种情况下,完整玻璃体切除术后的无晶状体眼是可行的选择。此外,我们重点介绍了植入后30多年与该IOL相关的临床表现.
    UNASSIGNED: To present a case involving a rarely seen prototype posterior chamber phakic IOL (PC-pIOL) in a highly myopic patient with bilateral cataract.
    UNASSIGNED: A 64-year-old male presented to our clinic with poor vision in both eyes. Clinical examination revealed bilateral mature cataract, phacodonesis as well as a PC-pIOL implanted 35 years ago to address his high myopia. The visual acuity (VA) was 20/200 in the right eye and no light perception in the left eye. PC-pIOL extraction as well as 23G pars plana vitrectomy (PPV) and fragmentation surgery was scheduled for the right eye. The left eye was treated conservatively. Successful extraction of the PC-pIOL was performed while it was easy to remove. It was a bow-tie shaped lens with a collar-stud-like button in the middle which extended anteriorly into the anterior chamber through the pupil. PPV with lens fragmentation was successful and the patient was left aphakic in order to avoid the placement of a zero diopter IOL. Final best corrected VA was 20/25 one month post-surgery.
    UNASSIGNED: Removal of this rarely seen pIOL was performed without difficulty while excellent VA was achieved. Aphakia following complete vitrectomy represented a viable option in this case. Furthermore, we highlight the clinical manifestations associated with this IOL more than three decades after implantation.
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  • 文章类型: Journal Article
    我们先前报道,在2010年至2014年期间评估的玻璃体切除术治疗玻璃体出血前3个月的高HbA1c水平或术前3个月的HbA1c水平大幅下降倾向于增加糖尿病视网膜病变患者的再出血风险。这里,我们旨在通过延长研究时间和增加手术眼的数量来证实这些结果.这项研究包括2010年至2019年在大阪大学医院住院并接受玻璃体切除术治疗玻璃体出血的121名糖尿病患者。以术后出血为结果进行二项logistic回归分析。本研究表明,手术持续时间与再出血有关(比值比=1.02,p=0.0016)。玻璃体切除术前的高HbA1c水平倾向于与出血相关(比值比=1.27,p=0.05),而术前HbA1c变化与再出血无关。这项研究的结果表明,术前HbA1c水平高,HbA1c水平没有下降,除了手术持续时间可能增加糖尿病视网膜病变患者玻璃体切除术后出血的风险.
    We previously reported that a high HbA1c level 3 months before vitrectomy for vitreous hemorrhage or a large preoperative decrease in the HbA1c level over 3 months tended to increase the risk of rebleeding in diabetic retinopathy patients evaluated between 2010 and 2014. Here, we aimed to confirm these results with an extended study period and an increased number of operated eyes. This study included 121 diabetic patients who were admitted to Osaka University Hospital between 2010 and 2019 and who underwent vitrectomy for vitreous hemorrhage. Binomial logistic regression analysis was performed with the presence of postoperative bleeding as the outcome. The present study showed that the duration of the operation was associated with rebleeding (odds ratio = 1.02, p = 0.0016). A high HbA1c level just before vitrectomy tended to be associated with the bleeding (odds ratio = 1.27, p = 0.05), while preoperative HbA1c changes were not associated with rebleeding. The results of this study suggest that a high preoperative HbA1c level just before vitrectomy, not a decrease in HbA1c levels, in addition to the duration of the operation may increase the risk of postoperative bleeding after vitrectomy in diabetic retinopathy patients.
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  • 文章类型: Journal Article
    目的:本研究的主要目的是评估剥离内界膜(ILM)的平坦部玻璃体切除术(PPV)的解剖和功能结果,膜蓝染色和随后的膨胀性气体填塞(全氟丙烷)治疗特发性黄斑裂孔(IMH)。
    方法:回顾性分析共100例IMH患者(61例女性和39例男性)的100只眼,2021年1月1日至2024年1月1日在斯洛伐克医科大学和布拉迪斯拉发大学医院眼科手术,使用25号PPV,ILM剥离和15%浓度的全氟丙烷填塞(C3F8).手术后,患者需要保持面朝下的姿势至少一周.最佳矫正视力(BCVA),光学相干断层扫描的最小线性直径(MLD),评估黄斑裂孔闭合类型及并发症发生情况。使用算术平均来表示所获得的结果并显示在图表中。
    结果:93例患者(93%)实现了黄斑裂孔的初级闭合。最常见的闭合类型是1A。手术后,所有患者的BCVA都有所改善,从术前的平均值0.101到手术后一年的平均值0.300。在所有患者组中(无论手术前黄斑孔的大小如何),在1年随访期间,BCVA逐渐增加,并稳定6个月.影响术后BCVA的主要因素为术前MLD和BCVA值。
    结论:PPV联合ILM剥离和全氟丙烷填塞是治疗特发性黄斑裂孔的有效方法,成功率达90%以上。这个外科手术,与相对较低的并发症有关,给患者带来明确的BCVA改善。
    OBJECTIVE: The main aim of this study is to evaluate the anatomical and functional results of pars plana vitrectomy (PPV) with peeling of the internal limiting membrane (ILM), membrane blue staining and subsequent expansile gas tamponade (perfluoropropane) in the treatment of idiopathic macular hole (IMH).
    METHODS: The retrospective analysis consisted of 100 eyes of a total of 100 patients (61 women and 39 men) with IMH, operated on at the Department of Ophthalmology of the Slovak Medical University and University Hospital Bratislava from 1 January 2021 to 1 January 2024, using 25-gauge PPV with ILM peeling and perfluoropropane tamponade (C3F8) of 15% concentration. After surgery, the patients were required to remain in a face-down position for at least one week. Best corrected visual acuity (BCVA), minimal linear diameter (MLD) on optic coherence tomography, macular hole closure type and occurrence of complications were evaluated. The obtained results were expressed with the use of arithmetic averages and displayed in graphs.
    RESULTS: Primary closure of macular hole was achieved in 93 patients (93%). The most frequently occurring type of closure was 1A. After surgery, the BCVA of all patients improved, from an average value of 0.101 preoperatively to 0.300 one year after surgery. In all groups of patients (regardless of the size of the macular hole before surgery), during the one-year follow-up period there was a gradual increase in BCVA with its stabilization by 6 months. The main factors that influenced postoperative BCVA were the preoperative values of MLD and BCVA.
    CONCLUSIONS: PPV with ILM peeling and perfluoropropane tamponade is an effective treatment for idiopathic macular holes with a success rate of more than 90%. This surgical procedure, associated with a relatively low number of complications, brings patients a definite improvement of BCVA.
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  • 文章类型: Journal Article
    比较倒置皮瓣技术和常规去除内界膜(ILM)在特发性黄斑裂孔(IMH)手术治疗中的功能和解剖学结果。
    我们回顾性评估了65例IMH手术患者的67只眼的解剖和功能结果。患者使用常规ILM剥离技术(第一组)或倒置ILM皮瓣技术(第二组)进行手术。将41例患者的43只眼纳入第一组,第二组患者24只眼。根据Gasse分类,我们仅指示IMH2-4期患者进行手术。最佳矫正视力(VA)始终在手术前和手术后两个月确定。此外,根据手术后的平均字母增益对两种技术进行了比较,并使用OCT评估IMH封堵是否成功的手术效果.对于这两种技术,用SF6填塞进行25GPPV。
    使用常规ILM去除在41只眼睛中进行了孔闭合。一只眼睛,即使使用相同的技术再次手术后,孔也没有关闭。ETDRS信值增益中位数为7.0。两眼的VA保持不变(4.7%),7例(16.2%)恶化,在所有其他病例中有所改善(79.0%)。16眼(37.2%),VA提高了2行或更多的ETDRS图表。使用倒置皮瓣技术,所有24只被监测的眼睛的孔都是封闭的。ETDRS信值中位数为9.5。两眼的VA保持不变(8.3%),2例(8.3%)恶化,在所有其他病例中有所改善(83.3%)。12只眼睛(50.0%)VA提高了2行或更多的ETDRS图表。术中、术后无严重并发症。
    我们的研究证明了两种方法的安全性和有效性。虽然结果没有统计学意义,倒置襟翼技术记录了更大的ETDRS字母增益(9.5与7.0)和闭孔比例(100%vs.95.3%)与我们的眼睛中的常规ILM剥离技术相比。
    To compare functional and anatomical outcomes between the inverted flap technique and conventional removal of the internal limiting membrane (ILM) in the surgical management of idiopathic macular hole (IMH).
    We retrospectively evaluated the anatomical and functional results in 67 eyes of 65 patients operated on for IMH. The patients were operated on either using the conventional ILM peeling technique (first group) or with the inverted ILM flap technique (second group). 43 eyes of 41 patients were included in the first group, 24 eyes of 24 patients in the second group. We indicated for surgery only patients with IMH stage 2-4 according to the Gasse classification. Best corrected visual acuity (VA) was always determined before and two months after surgery. Furthermore, a comparison of both techniques was made according to the average letter gain after surgery, and the effect of surgery was evaluated using OCT with regard to whether IMH closure succeeded. For both techniques, 25G PPV with SF6 tamponade was performed.
    Hole closure took place in 41 eyes with conventional ILM removal. In one eye, the hole did not close even after reoperation with the same technique. Median ETDRS letter gain was 7.0. VA remained the same in 2 eyes (4.7%), worsened in 7 cases (16.2%), and improved in all other cases (79.0%). In 16 eyes (37.2%), VA improved by 2 or more lines of ETDRS charts. Using the inverted flap technique, the hole was closed in all 24 monitored eyes. Median ETDRS letter gain was 9.5. VA remained the same in 2 eyes (8.3%), worsened in 2 cases (8.3%), and improved in all other cases (83.3%). In 12 eyes (50.0%), VA improved by 2 or more lines of ETDRS charts. There were no serious complications intraoperatively or postoperatively.
    Our study demonstrated the safety and efficacy of both methods. Although the results were not statistically significant, the inverted flap technique recorded a greater ETDRS letter gain (9.5 vs. 7.0) and proportion of closed holes (100% vs. 95.3%) compared to the conventional ILM peeling technique in our set of eyes.
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  • 文章类型: Journal Article
    目的:玻璃体切除术是治疗非创伤性和非糖尿病性视网膜疾病的关键干预措施之一。然而,接受此手术的患者的预后和影响预后的因素仍有待澄清。本研究旨在分析非创伤性和非糖尿病性视网膜病变并发玻璃体积血的预后因素。
    方法:对352例患者进行了回顾性研究,包括152名(43.18%)女性,2018年3月至2022年12月在我院行玻璃体切割手术患者,根据术后随访期间是否发生并发症分为A组(术后并发症)和B组(无并发症).收集并比较两组患者的一般情况和临床资料。采用二元Logistic回归分析影响预后的主要因素。
    结果:所有患者均随访12个月。共有87例患者出现术后并发症,占24.72%(87/352),共265例患者无术后并发症,占75.28%(265/352),术前视力差异有统计学意义。手术干预的时间,术前眼底情况,视网膜病变的阶段,两组患者术前眼压和年龄比较(p<0.05),这些指标被确定为影响患者预后的独立危险因素(比值比>1)。
    结论:术前视力,手术干预的时间,术前眼底情况,视网膜病变的阶段,术前眼压和年龄都是影响非创伤性和非糖尿病性视网膜病变患者在接受玻璃体切除术时预后的因素。需要个性化护理以改善这些患者的手术结果。
    OBJECTIVE: Vitrectomy is one of the crucial therapeutic interventions for non-traumatic and non-diabetic retinal diseases. However, the prognosis of patients undergoing this procedure and the factors affecting prognosis remain to be clarified. The aim of this study was to analyze the prognostic factors of non-traumatic and non-diabetic retinopathy complicated by vitreous hemorrhage.
    METHODS: A retrospective study was conducted on 352 patients, including 152 (43.18%) females, who underwent vitrectomy in our hospital from March 2018 to December 2022, divided into Group A (postoperative complications) and Group B (no complications) according to whether complications occurred during postoperative follow-up. General and clinical data of the two groups were collected and compared. Binary logistic regression was used to analyze the main factors affecting prognosis.
    RESULTS: All patients were followed up for 12 months. A total of 87 patients had postoperative complications, accounting for 24.72% (87/352), and were classified as Group A. A total of 265 patients who had no postoperative complications, accounting for 75.28% (265/352), were classified as Group B. There were significant differences in preoperative visual acuity, time of surgical intervention, preoperative fundus condition, stage of retinopathy, preoperative intraocular pressure and age between the two groups (p < 0.05), and these indices were identified as independent risk factors affecting the prognosis of patients (odds ratio >1).
    CONCLUSIONS: Preoperative visual acuity, time of surgical intervention, preoperative fundus condition, stage of retinopathy, preoperative intraocular pressure and age are all factors affecting the prognosis of patients with non-traumatic and non-diabetic retinopathy while undergoing vitrectomy. Personalized care is required to improve the surgical outcome for these patients.
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  • 文章类型: Case Reports
    一名61岁的马来西亚华裔男子患有高度近视,他抱怨两只眼睛都患有漂浮物。黄斑的谱域光学相干断层扫描(SD-OCT)显示双侧后葡萄肿,右眼(RE)黄斑裂孔,无黄斑脱离,在7年的随访中一直保持稳定。当双侧YAG激光玻璃体溶解不能缓解其症状时,他在玻璃体后脱离的情况下接受了平坦部玻璃体切除术,首先在左眼,一个月后的RE。双眼最佳矫正视力为术后2个月6/6,N5,他的漂浮物没有症状.然而,术后六个月,他抱怨说变形视和视力恶化。重复OCT显示双侧中心凹恶化,左中心凹脱离。患者必须进行重复的玻璃体切除术,并剥离双侧眼睛的内界膜(ILM),成功恢复了他的中央凹结构并缓解了他的症状。这篇文章强调了术前OCT评估在接受玻璃体切除术的漂浮物患者中中央凹的重要性。因为在近视患者中,玻璃体切除术期间染色和完全去除后泪液并进行ILM剥离可能会减轻核心玻璃体切除术后的黄斑裂进展。
    A 61-year-old Malaysian Chinese man who has high myopia complained of both eye floaters. Spectral-domain optical coherence tomography (SD-OCT) of the macula showed bilateral posterior staphyloma with right eye (RE) foveoschisis without macula detachment, which had been stable for a seven-year follow-up. When bilateral YAG laser vitreolysis could not alleviate his symptoms, he underwent pars plana vitrectomy with the inducement of posterior vitreous detachment, first in the left eye, followed by the RE one month later. The best-corrected visual acuity for both eyes was 6/6, N5 two months postoperatively, and he was asymptomatic for floaters. However, six months postoperatively, he complained of metamorphopsia and worsening RE vision. Repeat OCT showed worsening of the foveoschisis bilaterally with left foveal detachment. The patient had to undergo a repeat vitrectomy with peeling of the internal limiting membrane (ILM) in bilateral eyes, which successfully restored his foveal architecture and alleviated his symptoms. This article highlights theimportance of preoperative OCT assessment of the fovea in patients undergoing vitrectomy for floaters, as staining and complete removal of posterior hyaloid with ILM peeling during vitrectomy may mitigate the progression of foveoschisis after core vitrectomy for floaters in myopic patients.
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