| Objective:It’s recognized that pars plana vitrectomy(PPV)with internal limiting membrane peeling(ILMP)is preferred for the treatment of primary macular hole(PMH).We collected PMH at stage II~IV and compared the clinical efficacy and safety of air or C3F8 tamponade after PPV with ILMP,then analyzed associated factors for predicting postoperative vision.Methods: A total of 39 eyes of 39 patients with PMH that had received 23 G PPV with ILMP firstly diagnosed during Oct.2014 to Dec.2016 were retrospectively studied.They were divided into 2 groups.20 eyes in group 1 were filled with sterile air and 19 eyes in group 2 were filled with C3F8.All patients have been collected optical coherence tomography(OCT),intraocular pressure and the best corrected visual acuity(BCVA)pre-and-post operation.BCVA had to be transformed to log MAR then proceed following test by SPSS19.0 statistical tool:(1)within-group: paired T test to compare the log MAR-BCVA before and after operation.(2)between-group: T-test of independent sampler was used to analysis age,disease course,preoperative log MAR-BCVA,PMH morphological index,Operation time,postoperative log MAR-BCVA,CRT between the 2 group.Fisher exact probabilities was used to compare the closure rate and the incidences of complications between-group.(3)bivariate correlation analysis was used to analyze the relationship of postoperative vision and preoperative vision,age,disease course,the height of PMH,the destroyed length of EZ defined as A,the basal diameter defined as a,the minimum diameter defined as b,the sum of edge diameter defined as c+d(μm)and central retinal thickness(CRT),macular hole index(MHI),tractional hole index(THI),diametral hole index(DHI),hole form factor(HFF).there was a significant difference when P<0.05.Results: The differences of age(P=0.801),disease course(P=0.833),preoperative BCVA(P=0.478),H(P=0.370),A(P=0.836),a(P=0.533),b(P=0.362)between the two groups were not significant before operation(P>0.05).Visual acuity all improved by comparison of log MAR-BCVA before and after operation within-group,group 1(t=4.892,P=0.008),group 2(t=5.780,P=0.000),the difference was statistically significant(P <0.05).The differences of operation time(P=0.643),postoperative log MAR-BCVA(P=0.913),CRT at 1st month and 3nd month(P=0.976 、P=0.844),between-group were not significant before operation(P>0.05).At 1st month postoperative,the PMH closure rate was 100.0%.The differences of the closure rate at 1st week(P=1.000),the incidences of intraocular hypertension(P=0.342)and preretinal hemorrhage(P=1.000)between-group was statistically significant(P < 0.05).During the associated factors analysis,preoperative log MAR-BCVA(r=0.479,P=0.025),A(r=-0.450,P=0.035),a(r=0.-0.438,P=0.039),b(r=-0.657,P=0.012),MHI(r=0.589,P=0.040),THI(r=0.546,P=0.018)were statistically significant.(P<0.05),while age(r=0.361,P=0.090),disease course(r=-0.292,P=0.203),H(r=-0.235,P=0.314),DHI(r=-0.231,P=0.316),HFF(r=0.586,P=0.295)were not significant before operation(P>0.05).Conclusions: Air tamponade after PPV has the same efficacy and safety as C3F8 tamponade in the treatment of PMH.Preoperative BCVA,the basal diameter,the minimum diameter,the destroyed length of EZ,MHI,THI have correlation with postoperative vision.OCT have both diagnosis and forecast significance for PMH. |
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