Ocena funkcji wzroku, grubości siatkówki w regionie dołka oraz powikłań u pacjentów z idiopatycznym otworem w plamce leczonych metodą witrektomii tylnej z usunięciem błony granicznej wewnętrznej siatkówki – doświadczenia własne
Evaluation of Visual Function, Foveal Retinal Thickness and Complications after Macular Hole Surgery with Internal Limiting Membrane Peeling – Own Experience
Wojciech Gosławski, Wojciech Lubiński, Leszek Kuprjanowicz, Karol Krzystolik
Katedra i Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
Kierownik: dr hab. n. med. Wojciech Lubiński, prof. PUM, FEBO
Summary: Aim: Assessment of the best distance corrected visual acuity, subjective visual function, foveal retinal thickness and complications after macular hole surgery with inner limiting membrane peeling.
Material and methods: In 37 eyes of 37 patients (31/37 females – 83% and 7/37 males – 17%), mean age 68 ± 6 years standard pars plana vitrectomies (ppv 20 or 25G) with internal limiting membrane removal (stained with Briliant Peel) and intraocular gas tamponade (SF6 or C3F8) were performed. Mean follow-up time was 11 ± 8 months. Before surgery in 27 eyes (72%) stage III and in 10 eyes (28%) stage IV of idiopathic macular hole were detected. Before and after surgery distance corrected visual acuity (Snellen charts), subjective visual function, foveal retinal thickness (Stratus OCT 3000) were analysed. Additionally, frequency of macular hole closure and complications were assessed. Statistical analysis of obtained results was performed. P-value less than 0.05 was considered statistically significant.
Results: After surgery mean distance corrected visual acuity significantly improved from 0.11 ± 0.05 to 0.23 ± 0.1 (p<0.001). Subjective visual function improvement (especially metamorphopsia reduction) was achieved in 89% of patients (33/37). Mean foveal retinal thickness significantly decreased from 401 μm ± 108 μm to 253 μm ± 75 μm (p<0.0001). Total hole closure was observed in 78% of patients (29/37). Complications were detected in three eyes (8%) – in two eyes retinal detachments, in one eye choroidal detachment.
Conclusions: Significant improvement in visual function and decrease in foveal retinal thickness were obtained in patients with idiopathic macular hole treated by pars plana vitrectomy with inner limiting membrane peeling. Serious complications were rare. Our results are similar to those described in the literature.
Słowa kluczowe: idiopatyczny otwór w plamce, pars plana witrektomia – ppv, funkcja wzroku, grubość dołka, powikłania.
Keywords: idiopathic macular hole, pars plana vitrectomy – ppv, visual function, foveal thickness, complications.