Comparison of therapeutic effects between human amniotic membrane plugging and internal limiting membrane flap insertion for macular hole retinal detachment in high myopia
10.3760/cma.j.cn115989-20220121-00028
- VernacularTitle:人羊膜填塞与内界膜翻转填塞对高度近视黄斑裂孔性视网膜脱离疗效比较
- Author:
Chuqiao WANG
1
;
Jibo ZHOU
;
Tengteng YAO
;
Zeqi WANG
;
Huiqin GAO
;
Zhaoyang WANG
Author Information
1. 上海交通大学医学院附属第九人民医院眼科 上海市眼眶病眼肿瘤重点实验室，上海 200011
- Keywords:
Retinal detachment;
Vitrectomy;
High myopia;
Macular hole;
Amniotic membrane plugging;
Inverted internal limiting membrane flap insertion
- From:
Chinese Journal of Experimental Ophthalmology
2024;42(1):47-52
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of pars plana vitrectomy (PPV) combined with human amniotic membrane (hAM) plugging technique or internal limiting membrane (ILM) flap insertion technique for high myopia macular hole retinal detachment (MHRD).Methods:A non-randomized controlled clinical study was performed.Sixteen eyes of 15 patients with high myopia MHRD treated in the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from July 2020 to August 2021 were included.All patients underwent PPV and were divided into hAM plug group (7 eyes of 7 patients) and the ILM insertion group (9 eyes of 8 patients) based on the different plugging materials.The best corrected visual acuity (BCVA) and intraocular pressure were measured before surgery and at 1 week, 1, 3, and 6 months postoperative, respectively.Slit-lamp microscopy combined with lenses, scanning laser ophthalmoscope and optical coherence tomography (OCT) were used to examine the fundus, the macular hole closure and retinal reposition.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (No.SH9H-2021-T322-2). Written informed consent was obtained from each subject.Results:The retinal reattachment was achieved in 6 eyes in the hAM plug group and all 9 eyes in the ILM insertion group after initial surgery.The macular hole closure was observed in 5 eyes in the hAM plug group and 8 eyes in the ILM insertion group after initial surgery, and there was no statistical difference in the macular hole closure rate between the two groups ( P>0.05). There were significant differences in the overall comparison of BCVA between the two groups over time ( Ftime=4.420, P<0.05). Postoperative BCVA at different time points was better than preoperative BCVA in each group, but the differences were not significant (all at P>0.05). There was no significant difference in the overall comparison of BCVA between the two groups ( Fgroup=0.183, P>0.05). Two eyes in the hAM plug group and 4 eyes in the ILM insertion group developed transient ocular hypertension, which returned to normal after 1 week of treatment. Conclusions:Both PPV combined with hAM plugging technique and ILM insertion technique are safe and effective for the treatment of MHRD in high myopia.The hAM plugging technique can not only achieve anatomical reduction but also functional recovery of the retina even in complicated fundus conditions.
