内界膜剥除与不剥除术治疗特发性黄斑前膜的疗效对比观察

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目的比较单纯黄斑前膜剥除术、黄斑前膜剥除联合黄斑区内界膜剥除术两种手术方法治疗特发性黄斑前膜的疗效,探讨剥除视网膜内界膜对特发性黄斑前膜患者术后影响。方法回顾分析特发性黄斑前膜患者38只患眼的手术疗效。其中A组:黄斑前膜剥除联合内界膜剥除术18眼,B组:单纯黄斑前膜剥除术20眼。手术后随诊3个月以上,于手术前和手术后3个月时对患者行视力、MERG及OCT检查,分别对每组手术前后临床资料、两组之间临床资料进行分析。结果手术前两组患者的年龄、视力、黄斑中心凹厚度、MERG的1环和2环P波振幅及潜时均无明显差异。手术后3个月时两组视力较手术前均明显提高,黄斑中心凹厚度较手术前明显降低,A组术后MERG的1环和2环P波振幅明显降低,但术后3个月时两组之间视力、黄斑中心凹厚度、MERG潜时差异无显著性,A组MERG的振幅比B组有明显的降低。结论黄斑前膜剥除术是治疗特发性黄斑前膜的有效方法,内界膜剥除术在手术后短期内未显示其有效性,需进一步随访观察。 Objective To compare the curative effects of simple macular degeneration, macular membrane peeling and intramembranous macular degeneration in the treatment of idiopathic macular degeneration, and to explore the effects of stripping of the inner limiting membrane of the retina on idiopathic macular degeneration Postoperative membrane effects in patients. Methods Retrospective analysis of 38 patients with idiopathic macular degeneration patients with eye surgery. Group A: macular anterior membrane stripping combined with internal limiting membrane ablation in 18 eyes, group B: simple macular anterior membrane stripping in 20 eyes. The patients were followed up for 3 months or more before surgery and 3 months after surgery. Visual acuity, MERG and OCT were performed on the patients before and after surgery. The clinical data before and after each operation and the clinical data between the two groups were analyzed. Results There were no significant differences in age, visual acuity, foveal thickness, P wave amplitudes of 1st and 2nd ring of MERG and latency of the two groups before surgery. At 3 months after operation, the visual acuity of the two groups was significantly higher than that before the operation. The foveal thickness of the foveal was significantly lower than that before the operation. The amplitude of P wave in the first ring and the second ring of MERG group was significantly decreased in group A at 3 months postoperatively Visual acuity, macular foveal thickness and MERG latency were not significantly different between the two groups. The amplitude of MERG in group A was significantly lower than that in group B. Conclusion Anterior macular debridement is an effective method for the treatment of idiopathic macular dementia. The effectiveness of endarterectomy is not demonstrated shortly after operation, and needs further follow-up observation.
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