双孔玻璃体切除术在黄斑裂孔患者中的应用

I. Frolychev, D. V. Borisova, N. Pozdeyeva
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摘要

目的。双孔玻璃体切除术治疗黄斑裂孔的初步临床及功能结果分析。材料和方法。对15例诊断为黄斑裂孔的患者行双孔玻璃体切除术的治疗进行了分析。根据Gass分级,3期黄斑裂孔7例,4期黄斑裂孔8例。所有患者均采用微创玻璃体切除术。在手术开始时,安装了两个端口-一个用于内置照明器(吊灯)的输液套管,第二个用于玻璃体切割器。接下来,去除视网膜前膜(ERM)(如果有)和内限制膜(ILM),并在手术结束时使用富血小板血浆(PRP)。未发现术中及术后并发症。结果。患者治疗后最长观察时间为3个月。根据光学相干断层扫描(OCT),在所有病例中,解剖结果都达到了完全关闭黄斑孔。治疗3个月后BCVA平均值为0.32±0.08。在所有病例中,视觉功能均得到改善(p=0.035)。结论。双孔玻璃体切除术治疗黄斑裂孔可以达到良好的解剖效果,改善视觉功能,同时减少手术创伤。关键词:黄斑孔,富血小板血浆,双孔玻璃体切除术。
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Two-port vitrectomy in the treatment of patients with macular hole
Purpose. Analysis of the first clinical and functional results of treatment of patients with macular holes using the two-port vitrectomy. Material and methods. An analysis of treatment of 15 patients with a diagnosis of macular hole, operated by the method of two-port vitrectomy, was carried out. According to the Gass classification, 7 patients were diagnosed with stage 3 macular hole, and 8 patients with stage 4. All patients underwent microinvasive vitrectomy according to the developed technique. At the beginning of the operation, two ports were installed – one for the infusion cannula with a built-in illuminator (chandelier), the second for the vitreotome. Next, the epiretinal membrane (ERM) (if any) and the internal limiting membrane (ILM) were removed, and plateletrich plasma (PRP) was used at the end of the operation. Intra- and postoperative complications were not registered. Results. The maximum period of observation of patients after treatment was 3 months. In all cases, an anatomical result was achieved – complete closure of the macular hole according to optical coherence tomography (OCT). Mean BCVA results 3 months after treatment were 0.32±0.08. In all cases, improvement in visual functions was achieved (p=0.035). Conclusion. The method of two-port vitrectomy in the treatment of macular holes allows to achieve a good anatomical result, improve visual functions, while minimizing surgical trauma. Key words: macular hole, platelet-rich plasma, two-port vitrectomy.
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