摘要目的：观察特发性黄斑裂孔(IMH)玻璃体切割联合内界膜(ILM)手术后黄斑区视网膜厚度的变化。方法临床检查确诊的 IMH 患者40例40只眼纳入研究。其中,男性10例10只眼,女性30例30只眼。平均年龄(63.60±6.26)岁。平均病程(6.00±3.53)个月。所有患眼均行玻璃体切割联合 ILM剥除手术治疗,手术后黄斑裂孔均解剖闭合。手术后1、3、6个月,采用德国 Heidelberg 公司频域光相干断层扫描仪对黄斑区视网膜行水平、垂直扫描。测量黄斑中心凹、黄斑中心凹周围3 mm 环内及上方、颞侧、下方、鼻侧各象限视网膜厚度。观察手术后1、3、6个月黄斑区视网膜厚度变化情况；比较手术后6个月手术眼与对侧眼黄斑区视网膜厚度的差异。结果手术后1个月黄斑中心凹平均视网膜厚度与3、6个月比较,差异有统计学意义(F =4.527,P =0.013)；手术后3、6个月黄斑中心凹平均视网膜厚度比较,差异无统计学意义(F =2.031,P =0.971)。手术后1、3、6个月黄斑中心凹周围3 mm 环内平均视网膜厚度比较,差异均无统计学意义(F =2.011,P =0.139)。手术后1个月,手术眼与对侧眼黄斑中心凹平均视网膜厚度比较,差异无统计学意义(t=0.651,P =0.519)；手术后3、6个月手术眼与对侧眼黄斑中心凹平均视网膜厚度比较,差异有统计学意义(t=-2.563、-2.524,P =0.015、0.016),对侧眼黄斑中心凹平均视网膜厚度较厚。手术后1、3、6个月,手术眼颞侧平均视网膜厚度较对侧眼均变薄,差异有统计学意义(t =-3.701、-4.612、-4.125,P =0.014、0.006、0.009)。结论IMH 玻璃体切割联合 ILM 剥除手术后黄斑中心凹视网膜厚度出现一过性增厚；黄斑中心凹周围平均视网膜厚度未见此改变。

abstractsObjective To observe the changes of retinal thickness in idiopathic macular hole eyes after vitrectomy combined with internal limiting membrane peeling.Methods The study included 40 eyes in 40 consecutive patients with idiopathic full-thickness macular holes who underwent vitrectomy and internal limiting membrane peeling.There were 10 males (10 eyes)and 30 female (30 eyes),the average age was (63.60±6.26)years,the average disease duration was (6.00±3.53)months.All patients were examined by spectral-domain optical coherence tomography to measure the foveal retinal thickness,parafoveal retinal thickness and every quadrant in 1,3,6 months after surgery.Results Compared foveal retinal thickness after 1 month with 3 month,the difference was significant (F = 4.527,P = 0.013 ).But foveal retinal thickness were not significantly different in 3 months and 6 months after surgery (F =2.031,P =0.971 ). The difference of average parafoveal retinal thickness between 1 month,3 months and 6 months after surgery was not significant (F = 2.01 1,P = 0.139 ).The retinal thickness of the operated eyes were not significantly different from the normal fellow eyes in 1 month after surgery (t=0.65 1,P =0.5 1 9).And the foveal retinal thickness of the operated eyes and the normal fellow eyes are significantly different in 3 months and 6 months after surgery (t = - 2.563,- 2.524;P = 0.01 5,0.01 6 ).The thickness of temporal were thicker than other quadrant in 1 month,3months and 6 months after surgery (t = - 3.701,-4.612,-4.125;P =0.014,0.006,0.009).Conclusion There is a transient increase in the foveal retinal thickness after macular hole surgery.