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| Effect of vitrectomy combined with internal limiting membrane peeling on macular structure and function in high myopia patients with MHRD and analysis of the influencing factors of macular hole closure after operation |
| SHI Wei JIANG Na |
| Department of Ophthalmology, Hebei Handan Eye Hospital (the Third Hospital of Handan), Hebei Province, Handan 056000, China |
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Abstract Objective To investigate the effect of vitrectomy combined with internal limiting membrane peeling (ILMP) on macular structure and function in high myopia patients with macular hole retinal detachment (MHRD) and analysis of the influencing factors of macular hole closure after operation. Methods Clinical data of 69 patients with MHRD with high myopia treated with vitrectomy and ILMP in Hebei Handan Eye Hospital from February 2016 to August 2018 were retrospectively analyzed. According to the follow-up results of macular hole closure at three months after operation, they were divided into closed group (57 cases) and unclosed group (12 cases). All patients underwent optical coherence tomography, slit lamp microscopy and best corrected visual acuity before and after surgery. The changes of foveal retinal thickness (FRT), sub foveal choroidal thickness (SFCT), and the parameters and index of macular hole before and after operation were measured. Combined with clinical data of the patients, univariate and multivariate logistic regression models were used to analyze the influencing factors of macular hole closure. Results There were no significant differences in FRT and SFCT between two groups before operation (P > 0.05). After operation, FRT and SFCT of two groups were thinner than those before operation, and closed group was thinner than that unclosed group, the differences were statistically significant (P < 0.05). There were significant differences in MD, MHI and THI between two groups (P < 0.05). Multivariate logistic regression analysis showed that MD (OR = 1.003, 95%CI: 1.000-1.005, P = 0.048), MHI (OR = 108.369, 95%CI: 5.047-2326.771, P = 0.003) and THI (OR = 215.263, 95%CI: 2.248-20 609.444, P = 0.021) were independent risk factors for macular hole closure. Conclusion Vitrectomy combined with ILMP can significantly improve the macular structure and function in MHRD patients with high myopia. MD, MHI and THI are risk factors for macular hole closure.
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[1] Kenan S，Ali K. Macular buckling surgery for retinal detachment associated with macular hole in high myopia eye [J].Turk J Ophthalmol，2017，47（6）：351-354.
[2] Takahashi H，Inoue M，Koto T，et al. Inverted internal limi ting membrane flap technique for treatment of macular hole retinal detachment in highly myopic eyes [J]. Retina，2017，38（12）：2317-2326.
[3] Xu CZ，Wu JH，He JW，et al. Observation of single-layered inverted internal limiting membrane flap technique for macular hole with retinal detachment in high myopia [J]. Zhonghua Yan Ke Za Zhi，2017，53（5）：338-334.
[4] Callizo J，Pfeiffer S，Lahme E，et al. Risk of progression in macula-on rhegmatogenous retinal detachment [J]. Graefes Arch Clin Exp Ophthalmol，2017，255（8）：1-6.
[5] 谢肖莲，潘燕英，何洁丽，等.护理干预对玻璃体切割术患者视功能恢复的影响[J].中国医药导报，2014，11（15）：131-133，145.
[6] 任玫卿，常青.高度近视黄斑裂孔视网膜脱离玻璃体切割手术二期内界膜剥除治疗患眼的临床特征及疗效观察[J].中华眼底病杂志，2015，31（4）：329-332.
[7] 邓春梅，艾明，江双红，等.玻璃体切除联合内界膜剥离术治疗高度近视黄斑裂孔的疗效[J].国际眼科杂志，2015， 15（8）：1398-1401.
[8] 林静娜，辜智强，周悦，等.玻璃体切割术联合内界膜剥离术治疗黄斑裂孔性视网膜脱落[J].国际眼科杂志，2017， 17（3）：508-510.
[9] 徐武平，徐学东，孙驰平.玻璃体切割联合内界膜填塞术治疗高度近视黄斑裂孔性视网膜脱离[J].眼科新进展，2019，39（9）：857-860.
[10] 樊佳奇，吴苗琴.高度近视黄斑裂孔性视网膜脱离的研究进展[J].浙江医学，2018，40（10）：1138-1141，1149.
[11] 肖亚伟，郝玉华，尚庆丽，等.玻璃体切割联合内界膜剥除和巩膜缩短手术治疗高度近视黄斑劈裂疗效观察[J].中华眼底病杂志，2017，33（4）：373-377.
[12] 黄智华，谭薇，张英，等.内界膜翻转填塞与内界膜剥除治疗高度近视黄斑裂孔视网膜脱离的Meta分析[J].国际眼科杂志，2019，19（4）：571-576.
[13] 殷志博，闵思，魏玉华，等.玻璃体切除联合内界膜剥除术治疗高度近视黄斑劈裂临床研究[J].中国实用眼科杂志，2016，34（10）：1043-1048.
[14] 郭笑霄，王佳琳，王艳玲.玻璃体切除联合内界膜剥除治疗高度近视黄斑劈裂的研究进展[J].中国实用眼科杂志，2017，35（8）：753-755.
[15] 邹吉新，刘新，张立军，等.内界膜剥除联合C3F8填充治疗伴后巩膜葡萄肿的高度近视黄斑裂孔视网膜脱离[J].中华眼底病杂志，2016，32（5）：531-532.
[16] 陶继伟，俞雪婷，沈丽君，等.玻璃体切割联合内界膜剥除和气体填充手术治疗高度近视黄斑劈裂的疗效观察[J].中华眼底病杂志，2018，34（2）：111-115.
[17] 何情依，解正高.黄斑裂孔手术中内界膜剥除对视网膜结构及功能的影响[J].中华实验眼科杂志，2019，37（1）：51-54.
[18] 田超伟，王雨生，朱锦婷，等.玻璃体切割联合内界膜剥除手术治疗高度近视黄斑裂孔伴黄斑劈裂的疗效观察及黄斑裂孔闭合率的影响因素分析[J].中华眼底病杂志，2017，33（4）：359-363.
[19] 于海生，尹玉峰.手术剥离黄斑区内界膜治疗高度近视患者黄斑劈裂的疗效观察[J].临床眼科杂志，2018，26（3）：204-206.
[20] 宋爽，谷潇雅，卢颖毅，等.特发性黄斑裂孔患眼玻璃体切割手术后视力及裂孔闭合的影响因素分析[J].中华眼底病杂志，2017，33（4）：346-349. |
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