不同方向撕除内界膜方式对特发性黄斑裂孔术后视网膜位移的影响.

Objective: To compare two different internal limiting membrane (ILM) peeling pattern on the retinal displacement after closure of idiopathic macular hole (IMH). Methods: Twenty-five eyes from 25 patients with idiopathic macular hole were randomly allocated into two groups, NS-to-TI group (13 eyes) and TI-to-NS (12 eyes) group. For patients in NS-to-TI group, ILM was peeled off from nasal-superior retina to temporal-inferior retina. For patients in TI-to-NS group, ILM was peeled off from temporal-inferior retina to nasal-superior retina. Baseline, 1 month, and 3 months after surgery, autofluorescence fundus images were collected for measurement of distance between macular hole or foveal center to margin of optic disc (FMD), temporal vessel to optic disc (T-OD), nasal vessel to optic disc (N-OD), vertical Interarcade distance (VIAD), horizontal Interarcade distance (HIAD), and perimacular area (PMA) based on the retinal vessels with bifurcation or crossing on retina. The retinal displacement, macular hole closure rate, and best corrected visual acuity (BCVA) were compared between the two groups after surgery. Results: At 1 and 3 months after surgery, the macular seemed slippery to optic nerve, which manifested by the decreased FMD, T-OD, N-OD, VIAD, HIAD, PMA(P<0.05); no significant difference was found in the FMD, T-OD, N-OD, VIAD, HIAD and PMA between NS-TI group and TI-NS group. Both group yield 100 % macular hole closure rate. no obvious difference was found in the postoperative BCVA between the two groups (P<0.05). Conclusion: The two different ILM peeling pattern showed similar visual outcome and retinal displacement, which means the surgeons can peel the ILM with different grasp site and different orientation. [ABSTRACT FROM AUTHOR]