摘要目的 评价曲安奈德辅助玻璃体切除联合无染色内界膜剥除治疗Ⅳ期较大特发性黄斑孔的效果.方法 对Ⅳ期特发性黄斑孔27例(27眼)常规行视力、眼压和光相干断层扫描(OCT)等检查确定黄斑孔的分期.手术采用曲安奈德染色玻璃体,行人工玻璃体后脱离术和无染色黄斑区内界膜剥除.手术后2周和3个月复查视力、眼压和OCT.对比手术前后视力、眼压和黄斑孔直径情况.结果 手术前最佳矫正视力(logMAR) 1.7 ～1.0,平均为1.2±1.3,手术后3个月为1.6 ～0.8,平均为1.1±1.2,手术前后比较,差异有统计学意义(=3.38,P=0.027).手术后2周OCT检查显示,27只眼黄斑孔均闭合,达100％.所有患者均未发生眼压升高等并发症.结论 曲安奈德辅助玻璃体切除术联合内界膜剥除术治疗Ⅳ期黄斑孔是一种安全有效的方法.

abstractsObjective To evaluate the effect of triamcinolone-assisted vitrectomy and internal limiting membrane peeling without dye for the treatment of large size stage ⅣV idiopathic macular holes.Methods Twenty-seven eyes of 27 patients with stage Ⅳ idiopathic macular holes were collected.All patients underwent triamncinolone assisted vitrectomy,posterior vitreous detachment and internal limiting membrane peeling without dye.The best-corrected visual acuity (BCVA),intraocular pressure (IOP) and size of the macular hole measured with OCT before and after the surgery were analysed.Results The BCVA (logMAR) was 1.7-1.0,average of the BCVA was (1.2 ± 1.3) before surgery.The BCVA (logMAR) was 1.6-0.8,average of the BCVA was (1.1 ± 1.2) at 3 months after surgery.Compared with the preoperative level,the difference was statistically significant (t =3.38,P =0.027).Anatomic macular hole closure was achieved in 27 eyes(100％)at 2 weeks after surgeny,the difference in vision improvement was statistically significant (t =3.380,P =0.027).The postopertive BCVA increased in 25 eyes (92.6％) and kept unchanged in 2 eyes (7.4％).No severe complications were noted.Conclusion Vitrious dyed by TA and vitrectomy ILM peeling without dye is an effective and safe surgical technique in stage Ⅳidiopathic macular holes.