摘要目的 探讨广角视野系统辅助下23G玻璃体切割术治疗特发性玻璃体黄斑牵引综合征的临床效果.方法 对2012年3～12月在南昌大学第二附属医院眼科就诊的患者经裂隙灯前置镜、间接眼底镜检查、B超、光学相干断层扫描(OCT)等检查确诊为玻璃体黄斑牵引综合征行玻璃体手术30例(30只眼)的临床资料进行回顾性分析.所有患者至少随访6个月,主要评估参数为手术后1,3,6个月时的最佳矫正视力(BCVA)和黄斑中心厚度(CMT).结果 所有患者平均随访时间为7(6～15)个月.平均术前BCVA为(0.910±0.119) LogMAR.末次随访时BCVA为(0.327±0.091) LogMAR (P=0.000).基线时的平均CMT为(550.870±20.032) μm,末次随访时降至(255.300±4.112) μm (P=0.000).CMT平均下降(295.57±20.748) μm.所有患者均无眼内炎、视网膜脱离、低眼压或青光眼等术后并发症发生.结论 广角视野系统辅助下的23G玻璃体切割术能有效解除玻璃体对黄斑部的牵引,阻止患者视力进一步下降,减轻黄斑水肿及渗漏,是治疗玻璃体黄斑牵引综合征的有效方法.

abstractsObjective To evaluate the outcomes of patients with vitreomacular traction syndrome (VMT) treated with wide-angle viewing system assisted 23-gauge (23-G) transconjunctival sutureless vitrectomy.Methods A retrospective case series.The medical charts of 30 conseeutive patients (30 eyes) with VMT who underwent wide-angle viewing system assisted 23-gauge transconjunctival pars plana vitrectomy were reviewed.All patients had at least six-month follow-up.The main outcome parameters were changes in best corrected visual acuity (BCVA) and central macular thickness (CMT) between the baseline and postoperative follow-up examinations performed at the first,third,and sixth months after the surgery.Results The mean follow-up period was 7 (range 6-15) months.The mean preoperative BCVA was 0.910±0.119 (logmar).The final BCVA was 0.327±0.091 (logmar) (P=0.000).The mean CMT was 550.870±20.0321μm at baseline,which was significantly reduced to 255.300±4.112μm at the final follow-up visit (P=0.000).The mean CMT reduction was 295.57± 20.748μtm.No postoperative complications were seen such as endophthalmitis,retinal detachment,hypotony,or glaucoma.Conclusions Wide-angle viewing system assisted 23-G transconjunctival sutureless vitrectomy is an effective and safe surgical technique in the management of VMT syndrome.Further studies with large case series are needed.