| 目的：探讨不同类型黄斑前膜手术疗效及术前黄斑形态对术后视力影响。方法：收集我院2004年9月到2006年2月的 21 例（22眼）黄斑前膜病例，行玻璃体切除及前膜剥除手术，术前及术后行眼科常规检查，随访1年。结果：共收集黄斑前膜病例21例（22眼），病程最短1个月，最长4年。包括特发性黄斑前膜13例，继发黄斑前膜8例（9眼），其中巩膜扣带术后2眼，伴随孔源性视网膜脱离2眼，继发于视网膜血管病变的为5眼。所有病例术前行OCT检查，其中合并玻璃体牵拉2眼，合并板层黄斑裂孔3眼。术前特发性黄斑前膜组黄斑中心凹视网膜厚度为386um，继发性黄斑前膜组黄斑中心凹视网膜厚度364um。所有患者均行玻璃体切除术。术后视物变形改善率为71%，均有不同程度视力提高，其中视力提高2行及以上者特发性黄斑前膜组为9眼，继发黄斑前膜组为2眼。对于两种类型黄斑前膜，特发性黄斑前膜术后视力改善较继发性黄斑前膜明显（P=0.0365<0.05）。结论；对于不同类型黄斑前膜，特发性黄斑前膜手术后视力改善明显。术前中心凹视网膜厚度与术后视力成负相关，中心凹视网膜越厚，术后视力越差。
Objective:To evulate the surgical effect of different types of epiretinal macular menmbranes and the impaction of the membrane shape in preoperation on visual acuity in postoperation. Method:A retrospective analysis of 22 eyes of epiretinal macular membranes in my hospital from 2004.9 to 2006.12, vitrectomy was made .Routine examinations were made in preoperation and postoperation,all patients follow-up to one year. Results:There were 21patients(22eyes),including idiopathic epiretinal macular membrane(13eyes) and secondary epiretinal macular membrane(9eyes).in secondary epiretinal macular membrane group,there were buckling group(2eyes),with RRD (2eyes) and with retinal vessel diserse(5eyes).OCT examinations were made in preoperation.In preoperation,the average thickness of idiopathic epiretinal macular membrane is 386um,then the average thickness of idiopathic epiretinal macular membrane is 364um. Vitrectomy was made.The improvement rate of distortion is 71.0% .9eyes of idiopathic epiretinal macular membrane had a visual acuity improvement of more than 2lines,2 eyes of secondary epiretinal macular membrane had a visual acuity improvement of more than 2lines. Idiopathic epiretinal macular membrane has a better visual acuity improvement than secondary one(P=0.0365<0.05). 。Conclusions:During to different types of epiretinal macular membranes, idiopathic epiretinal macular membrane has a better suigical effect than secondary one.There is negative correlation in macular thickness preoperation and visual acuity postoperation. |
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