Clinical outcomes of vitrectomy with air tamponade and 1-day prone positioning in the treatment of idiopathic macular hole
10.3760/cma.j.cn511434-20190508-00172
- VernacularTitle:玻璃体切割手术联合空气填充及俯卧位一天治疗特发性黄斑裂孔的疗效观察
- Author:
Juping LIU
1
;
Liangyu HUANG
;
Xinjun REN
;
Xiaorong LI
Author Information
1. 天津医科大学眼科医院、眼视光学院、眼科研究所 天津市视网膜功能与疾病重点实验室天津市眼科学与视觉科学国际联合研究中心 300384
- From:
Chinese Journal of Ocular Fundus Diseases
2020;36(7):499-503
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the surgical outcomes of 25G + vitrectomy with air tamponade and 1-day prone positioning for idiopathic macular hole (IMH). Methods:A prospective analysis was performed on 39 patients (39 eyes) underwent 25G + pars plana vitrectomy (PPV) combined with the internal limiting membrane (ILM) removal and fluid-air exchange for IMH from July 2012 to December 2013. After vitrectomy, patients were instructed to keep prone positioning for only 1 day (the air group). These patients were compared to 30 consecutive patients from July 2010 to July 2012, who were conducted 25G + PPV with 25% SF 6 tamponade. They remained in the same face-down position for 3 days postoperatively (SF 6 group). Age, gender, logMAR BCVA, macular thickness, macular hole diameter, axial length, macular hole stages and pseudophakic status were collected as baseline characteristics in both groups. The initial hole-closure rate, visual outcome and intra-operative & post-operative complications were evaluated for 6 months. Group comparisons of numeric variables were made by using two sample t-test. Group difference of categorical variables was determined by using standard chi-square test or rank sum test. Results:Thirty nine patients (39 eyes) and 30 patients (30 eyes) were respectively enrolled in air group and SF 6 group. The distribution of age ( t=-1.63), gender ( χ 2=0.03), logMAR BCVA ( t=0.39), macular thickness ( t=-0.93), macular hole diameter ( t=-0.70), axial length ( t=-0.56), macular hole stages ( Z=-0.47) and pseudophakic status ( χ 2=0.13) was similar in both groups. Anatomical closure of macular holes was achieved in 35 (89.7%) of the 39 eyes in the air group and in 27 eyes (90.0%) in the SF 6 group. There was no significant difference of closure rate between the two groups ( χ 2=0.001, P=0.970). The postoperative visual acuity of gaining, stability and decreasing 2 or more 2 lines was achieved in 23 eyes, 10 eyes and 6 eyes in air group and 18 eyes, 6 eyes and 6 eyes in SF 6 group. The proportion of visual acuity improvement in air group was lower than that in SF 6 group without the statistical significance ( Z=-0.08, P=0.93). The gas bubble was absorbed sooner in the air group (mean 8.54±1.74 days) than in the SF 6 group (mean 31.10±3.20 days). No retinal break, retinal detachment or endophthalmitis occurred in either group. Postoperatively intraocular pressure was elevated temporarily in 2 eyes of the air group and 3 eyes in the SF 6 group. All returned to normal limit after local medication. Conclusion:Compared to SF 6 group, air group has similar anatomical macular hole closure rate and visual acuity rehabilitation.
