Novel surgical technique for macular holes with basal diameter >1000 μ

IF 1 Q4 OPHTHALMOLOGY Taiwan Journal of Ophthalmology Pub Date : 2023-10-18 DOI:10.4103/tjo.tjo-d-23-00025
Debdulal Chakraborty, Soumen Mondal, Sabyasachi Sengupta, Subhendu Boral, Arnab Das
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Abstract

Abstract: Closure rate of full-thickness macular holes (FTMHs) with basal diameter >1000 μ is known to be poor. Patients presenting with FTMH having a minimum basal diameter of >1000 μ without any coexistent retinal morbidity were offered vitrectomy, internal limiting membrane peeling, retinal massage, and aspiration of subretinal fluid from the MH. Visual acuity (VA) and spectral-domain optical coherence tomography (SD OCT) assessments were performed at baseline, week 1 after surgery and at postoperative months 1, 3, 6, and 12. VA, type of hole closure, presence of ellipsoid zone, and external limiting membrane defect were monitored. The primary endpoint was type 1 anatomical hole closure. Secondary outcome measure was a change in VA from baseline to 6-month follow-up and persistent hole closure at the final follow-up of 12 months. The mean age was 67.1 ± 9.1 years. Seven eyes were pseudophakic, and two underwent combined phacoemulsification with MH surgery. The mean minimum basal diameter of FTMH was 1162.4 ± 161 μ. The mean duration of visual loss was 11.3 ± 1.93 months. Type 1 closure of FTMH was seen in all patients on SD OCT, on the 7 th postoperative day. The mean presenting VA was 1.06 ± 0.1 Logarithm of the minimum angle of resolution (logMAR). Best-corrected visual acuity improved to 0.91 ± 0.09 logMAR at 1-month follow-up ( P = 0.005) (95% confidence interval [CI]: 0.061–0.251), 0.63 ± 0.1 logMAR ( P < 0.001) (95% CI 0.339–0.527) at 3 months, and 0.55 ± 0.05 logMAR ( P < 0.001) (95% CI 0.414–0.609) at 6 months. All holes were found closed at the final follow-up of 12 months. This novel technique can help achieve better outcomes and raise the primary anatomical success rate of FTMH with basal diameter >1000 μ.
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基底直径1000 μ的黄斑孔的新手术技术
摘要:基底直径为>1000 μ的全层黄斑孔闭合率较差。基底直径最小为1000 μ且无任何并发视网膜病变的FTMH患者接受玻璃体切除术、内限制膜剥离、视网膜按摩和从MH吸出视网膜下液。在基线、手术后第1周和术后1、3、6和12个月进行视力(VA)和光谱域光学相干断层扫描(SD OCT)评估。监测VA、闭孔类型、椭球带的存在和外限制膜缺陷。主要终点为1型解剖孔闭合。次要结果测量是从基线到随访6个月的VA变化,以及在最后随访12个月时持续的孔闭合。平均年龄67.1±9.1岁。7只眼为假性晶状体,2只行超声乳化术联合MH手术。FTMH平均最小基底直径为1162.4±161 μ。平均视力下降时间为11.3±1.93个月。术后第7天,所有患者的SD OCT显示FTMH为1型闭合。VA的平均值为最小分辨角(logMAR)的1.06±0.1对数。随访1个月,最佳矫正视力改善至0.91±0.09 logMAR (P = 0.005)(95%可信区间[CI]: 0.061-0.251), 0.63±0.1 logMAR (P <0.001) (95% CI 0.339-0.527)和0.55±0.05 logMAR (P <0.001) (95% CI 0.414-0.609)。在12个月的最后随访中发现所有孔都闭合。该方法可提高基底直径为1000 μ的FTMH的初步解剖成功率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.80
自引率
9.10%
发文量
68
审稿时长
19 weeks
期刊最新文献
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