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Effect of internal limiting membrane peeling and transplantation on vision-related quality of life in refractory macular hole

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Journal Title:
Chinese Journal of Ocular Fundus Diseases
Key Word:
视网膜穿孔/外科学;玻璃体切除术;内界膜剥除;内界膜移植;视功能相关生存质量;Retinal perforations/surgery;Vitrectomy;Internal limiting membrane peeling;Internal limiting membrane transplantation;Vision-related quality

Abstract´╝Ü Objective To observe the effect of internal limiting membrane peeling and transplantation on vision-related quality of life in refractory macular hole.Methods A retrospective clinical study.Thirty patients (30 eyes) with refractory macular hole diagnosed in Ophthalmology Department of The First Affiliated Hospital of Nanjing Medical University from January to December 2016 were included in this study.There were 13 males (13 eyes) and 17 females (17 eyes),with the mean age of 57.3 ± 6.9 years.There were 15 patients (15 eyes) with large macular diameter,12 patients (12 eyes) with high myopia macular hole,and 3 patients (3 eyes) with secondary traumatic macular hole.The BCVA examination was performed using the Snellen visual acuity chart,which was converted into logMAR visual acuity.OCT was performed to measure the macular retinal thickness (CRT),base diameter and minimum diameter of macular hole.Then,the macular hole index (MHI) was calculated.The logMAR BCVA was 1.52±0.30,MHI was 0.51 ±0.19.The Chinese version of visual-related quality of life scale-25 (CVRQoL-25) was used to evaluate the vision-related quality of life of patients.The CVRQoL-25 score was 57.60±7.13.All patients underwent 23G vitrectomy combined with inner limited membrane peeling and autologous ILM transplantation.The follow-up was at least 3 months after surgery.The changes ofBCVA,MHI,CRT and CVRQoL-25 score before and after surgery were comparatively analyzed.Paired t test was performed to compare the measurement data before and after surgery,and Spearman rank correlation analysis was used for the correlation analysis among the parameters.Results At 3 months after surgery,the hole closure was detected in 28 eyes (93.3%),not detected in 2 eyes (6.7%).The logMAR BCVA was 1.16± 0.33,CRT was 161.00± 15.26,and CVRQoL-25 scores was 70.83 ± 9.77.Compared with before surgery,the BCVA (t=4.386,P=0.000) and CVRQoL-25 score (t=-5.991,P=0.000) after surgery were improved.Spearman rank correlation analysis showed that CVRQoL-25 score was negatively correlated with preoperative and postoperative logMAR BCVA (r=-0.536,-0.796;P=0.002,0.000);positively correlated with preoperative MHI (r=0.421,P=0.020) and postoperative CRT (r=0.589,P=0.001).Conclusion Internal limiting membrane peeling and transplantation for refractory macular hole can significantly improve the vision-related quality of life and visual acuity,while achieved a high hole closure rate (93.3%).

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