摘要目的 观察玻璃体切割(PPV)联合保留中心凹内界膜(ILM)剥除手术治疗高度近视黄斑劈裂(MF)的长期临床疗效.方法 前瞻性病例系列研究.2015年12月至2016年12月于温州医科大学附属眼视光学院杭州院区检查确诊连续治疗的高度近视MF患者15例15只眼纳入研究.其中,男性4例4只眼,女性11例11只眼;平均年龄(55.33±8.34)岁.患者均行BCVA、屈光度、频域OCT检查以及眼轴长度测量.患眼平均logMAR BCVA 0.95±0.64;平均中心凹视网膜厚度(CFT)(576.00±185.32)μm.均接受标准经睫状体平坦部三通道23G微创PPV.手术中清除玻璃体后皮质膜,吲哚青绿辅助染色黄斑区ILM,旁中心凹区连续或间断环形撕除ILM,气液交换后,眼内填充12％C3F8.手术后平均随访时间(17.5±4.5)个月.手术后1、3、6、12个月及末次随访时,采用与手术前相同的设备和方法进行相关检查.观察BCVA、黄斑区结构变化.结果 所有患眼手术中均成功保留中心凹ILM.末次随访时,患眼平均CFT(258.60±175.22)μm,平均logMAR BCVA 0.46±0.43.与手术前比较,CFT降低,logMAR BCVA提高,差异均有统计学意义(t=4.90、5.20,P<0.001).15只眼中,MF愈合13只眼,BCVA提高14只眼.手术后出现ILM增生皱缩5只眼;并发全层黄斑裂孔1只眼.结论 PPV联合保留中心凹ILM剥除手术治疗高度近视MF长期疗效较好,BCVA和CFT均得到改善.

abstractsObjective To observe the long-term clinical effect of pars plana vitrectomy combined with fovea-sparing internal limiting peeling in the treatment of macular foveoschisis in pathologic myopic. Methods A prospective case series study. Fifteen patients (15 eyes) with pathological myopic macular foveoschisis who received treatment in Eye Hospital of Wenzhou Medical University from December 2015 to December 2016 were enrolled. There were 4 males (4 eyes) and 11 females (11eyes), with an average age of 55.33±8.34 years. All patients underwent BCVA, diopter, spectral domain OCT and axial length measurement. The mean logMAR BCVA was 0.95±0.64. The mean central fovea thickness (CFT) was 576.00±185.32 μm. All patients underwent vitrectomy combined with fovea-sparing internal limiting peeling. After gas-liquid exchange, 12％ C3F8 was filled and followed up at 1, 3, 6 and 12 months after surgery. Follow-up time was more than 12 months. The structural changes of BCVA and macular area were observed.Results The foveal internal limiting membranes was successfully preserved in all eyes using the techinique. At the final follow-up, the CFT was 258.60±175.22 μm and the BCVA was 0.46±0.43, which were significantly improved compared with preoperative measurements (t=4.90, 5.20;P<0.001). Macular foveoschisis was resovled in 13 eyes. BCVA increased in 14 eyes. Internal limiting membranes proliferation and contraction occurred in 5 eyes and full-thickness macular hole occurred in 1 eye.Conclusions Pars plana vitrectomy with fovea-sparing internal limiting peeling is effective in the treatment of myopic macular retinoschisis. It can improve BCVA and CFT.