机构：[1]Shandong Eye Hospital, Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University, Jinan, China[2]Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China[3]National Clinical Research Center for Eye Diseases[4]Shanghai Clinical Research Center for Eye Diseases[5]Shanghai Key Clinical Specialty[6]Shanghai Key Laboratory of Ocular Fundus Diseases[7]Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China[8]Shibei Hospital, Jing’an District, Shanghai, People’s Republic of China[9]Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, People’s Republic of China
PurposeThe aim of this study was to assess the efficacy and safety of a novel releasing-closing-tapping approach in the treatment of persistent macular holes (PMHs) after initial surgery with internal limiting membrane (ILM) peeling.MethodsWe retrospectively analyzed patients with PMHs after initial surgery with ILM peeling who were treated with a novel releasing-closing-tapping approach. After repeated pars plana vitrectomy (PPV), the surgeon effectively released the adhesion between the edges and retinal pigment epithelium (RPE) by gently scraping the retinal neuroepithelium. Then, the hole was converted into a transverse slit, and the edges were gently tapped flat so that they attached to the RPE, and no space was left under the edges. Finally, air tamponade was carried out. The primary outcome measures included MH closure and the change in best-corrected visual acuity (BCVA) from preoperatively to postoperatively.ResultsThe study included 11 PMH patients with a mean age of 63.82 & PLUSMN; 3.31 years. The mean minimum linear diameter of PMHs was 666.3 & PLUSMN; 208.1 & mu;m, and the mean basal diameter was 1547.2 & PLUSMN; 351.8 & mu;m. MH closure was achieved in 90.9% (10/11) of eyes, with significant improvement of visual acuity from 1.19 & PLUSMN; 0.30 logMAR to 0.65 & PLUSMN; 0.29 logMAR postoperatively.ConclusionThe releasing-closing-tapping approach with repeated PPV is a simple, effective, and safe surgical procedure for refractory PMHs after initial surgery with ILM peeling that can significantly improve the visual outcome and achieve a high surgical success rate.
基金：
National Natural Science Foundation of China [81970811]; Domestic Science and Technology Cooperation Project of Shanghai Municipal Science and Technology Commission [21015800700]; National Key Ramp;D Program of China [2019YFC0840607]
第一作者机构：[1]Shandong Eye Hospital, Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University, Jinan, China
共同第一作者：
通讯作者：
通讯机构：[2]Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China[3]National Clinical Research Center for Eye Diseases[4]Shanghai Clinical Research Center for Eye Diseases[5]Shanghai Key Clinical Specialty[6]Shanghai Key Laboratory of Ocular Fundus Diseases[7]Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, China
推荐引用方式(GB/T 7714)：
Su Tong,He Shuai,Mao Peiyao,et al.A three-step approach to close refractory persistent macular holes: a releasing-closing-tapping approach[J].GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY.2023,261(12):3415-3423.doi:10.1007/s00417-023-06197-9.
APA：
Su, Tong,He, Shuai,Mao, Peiyao,Gu, Chufeng,Meng, Chunren...&Qiu, Qinghua.(2023).A three-step approach to close refractory persistent macular holes: a releasing-closing-tapping approach.GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY,261,(12)
MLA：
Su, Tong,et al."A three-step approach to close refractory persistent macular holes: a releasing-closing-tapping approach".GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY 261..12(2023):3415-3423
