Clinical outcomes of C3F8 and air tamponade after vitrectomy for the treatment of idiopathic macular hole

目的 比较玻璃体切割手术联合空气或C3 F8填充治疗特发性黄斑裂孔(MH)的疗效.方法临床确诊为特发性MH并行23G玻璃体切割联合内界膜剥除手术治疗的54例患者54只眼纳入研究.其中,气液交换后注入消毒空气26只眼(空气填充组),气液交换后注入10％C3F8 28只眼(C3F8填充组).所有患眼均行最佳矫正视力(BCVA)及频域光相干断层扫描(SD-OCT)检查.空气填充组患眼中,MH分期为Ⅱ期6只眼,Ⅲ期20只眼;MH最小直径(Dmin)＜400μm、＞400 μm分别为14、1 2只眼.C3F8填充组患眼中,MH分期为Ⅱ期10只眼,Ⅲ期18只眼;MH Dmin＜400 μm、＞400 μm分别为15、1 3只眼.两组患者年龄、病程、BCVA及MH基底直径、Dm、高度、指数及外层视网膜缺失直径(Dord)比较,差异均无统计学意义(P＞0.05).对比分析手术前及手术后1个月两组患眼的MH闭合率及BCVA、MH Dord的变化.结果 手术后1个月,空气填充组、C3F8填充组患眼MH闭合率分别为100.0％、92.9％.两组患眼MH闭合率比较,差异无统计学意义(P=0.491).空气填充组和C3F8填充组MH Dmin＜400 μm的患眼MH闭合率均为100.0％;Dmin＞400 μm的患眼MH闭合率分别为100.0％、84.6％.两组MH Dmin＞400μm患眼的MH闭合率比较,差异无统计学意义(P=0.480).空气填充组、C3F8填充组患眼平均BCVA分别为0.35±0.22、0.33±0.16;MH平均Dord分别为(782.2±478.0)、(792.1±432.7) μm.两组患眼手术后BCVA较手术前明显提高(t=-7.310、-10.506),MH平均Dord较手术前明显缩短(t=6.704、7.770),差异均有统计学意义(P＜0.01).两组患眼手术后BCVA、MH平均Dord比较,差异均无统计学意义(t=0.381、-0.800,P=0.705、0.937).结论 玻璃体切割手术联合空气或C3F8填充治疗特发性MH的疗效相当.Objective To compare the clinical effect of C3F8 and air tamponade after vitrectomy for the treatment of idiopathic macular hole (IMH).Methods A total of 54 eyes of 54 patients with IMH that had undergone 23G pars plana vitrectomy with internal limiting membrane peeling were retrospectively studied.All patients received optical coherence tomography ()CT) examination and the best corrected visual acuity (BCVA).They were divided into 2 groups.26 eyes in group A were filled with air and 28 eyes in group B were filled with C3F8.In group A,6 eyes at stage Ⅱ,20 eyes at stage Ⅲ,the minimum diameter (Dmin) of macular hole in 14 eyes was less than 400 μm,and in the other eyes was larger than 400 μm.In group B,10 eyes at stage Ⅱ,18 eyes at stage Ⅲ,the Dmin of macular hole in 15 eyes was less than 400 μm,and in the other eyes was larger than 400 μm.The differences of age,course of the disease,BCVA,fundus diameter,Dmin,height,index,diameter of outer retina diameter (Dord) between the two groups were not significant (P＞0.05).The basic data before surgery and the closure rate,BCVA,Dord 1 month after surgery between two groups were compared.Results At 1 month after surgery,the IMH closure rate was 100.0％ in group A and 92.9％ in group B,the difference between these two groups was not significant (P=0.491).The closure rate of eyes with Dmin＜400 μm were both 100.0％ in two groups,and the closure rate of eyes with Dmin＞400 μm were 100.0％ in group A and 84.6％ in group B.There was no statistically significant differences between two groups (P =0.480).The mean BCVA of two groups were 0.35±0.22 and 0.33 ±0.16 respectively.The mean Dord were (782.2 ± 478.0) μm and(792.1 ± 432.7) μm respectively.All cases got better BCVA (t=-7.310,-10.506;P＜0.01) and shorter Dord (t=6.704,7.770;P＜0.01).But there was no statistically significant differences between groups 1 month after surgery in BCVA and Dord (t =0.381,0.800;P =0.705,0.937).Conclusion Air tamponade after vitrectomy has the same efficacy as C3 F8 tamponade in the treatment of IMH.中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)5473-4773