Clinical Observation Of Conservative And Surgical Treatment Of Traumatic Macular Hole

PURPOSE:Observation and in the healing of traumatic macular hole andconservative surgery vision of the outcome, for the choice of treatment,prognosis assessment to provide the reference。METHODS:Collected22cases (22eyes) of traumatic macular holecases, including12cases (12eyes) with conservative treatment andsurgical treatment of10cases (10eyes). Detection of visual functionbefore and after the treatment outcome, statistics in closing time, testingorganizations in all phases of the morphological variation characteristics,followed up for12months, will the stages before and after conservativetreatment and surgical treatment of histological characteristics,characteristics of visual function and its relationship to do statisticsanalysis.RESULTS:一、Conservative treatment,12cases (12eyes):(1) in8cases (8eyes) with spontaneous closure, accounted for66.7%, occurredin closed between1~6months, closed in aperture in53um to340um,closed in patients aged from15to30years old, eyesight improve6cases (6eyes), accounted for75%, stagnating or declining eyesight in2cases (2eyes), accounting for25%.(2) not closed4cases (4eyes),accounted for33.3%, not closed in aperture in320~651um, in notclosed patients aged between38to61years old, eyesight improve in1case (1eye), accounted for25%, stagnating or declining eyesight3 cases (3eyes), accounting for75%.(3) closed: vision changes in closed3months after statistically difference (he Chi Square test x2=2.28, P <0.05), suggesting that conservative treatment in closed after3monthshas not been closed closed eyesight better than vision improved. In aclosed and conservative treatment was not closed aperture size wasstatistically difference (t=2.58, p <0.05, see table3), the spontaneousclosure in diameter of less than not closed in diameter, suggests thatpatients with conservative treatment in the smaller closure.(4) not closed:injury after1month,6months,12months vision changes no statisticaldifferences (he Chi Square test x2=5.13, P>5.13). Patients presentedaperture at470.0±163.45um,6months after injury in aperture at502.23±163.74um,12months after injury in aperture at608.45±281.63um, showed that after12months after injury in aperture is still unstable.二、The surgical treatment of patients with10cases (10eyes):(1)closed in8cases (8eyes), accounted for80%, patients presented in253um to1757um in diameter, closed patients aged between20~60yearsold, eyesight improve in5cases (5eyes), accounted for62.5%,stagnating or declining eyesight3cases (3eyes), accounting for37.5%.(2) in not closed in2cases (2eyes), accounted for20%, not closed, a67-year-old age of52, respectively, are not closed crack aperture,respectively for1216patients with1757um, um, vision remains thesame in1case (1eye) accounted for50%, vision loss in1case (1eye), accounting for50%.(3) closed: vision changes in closed3months afterstatistically difference (he Chi Square test x2=2.45, P <0.05),suggesting that3months after surgery in closed closed eyesightimprove vision than not closed. Has not been closed surgery in closedand aperture size was statistically difference (t=1.69, p <0.05, areshown in table5). Surgical closure in diameter of less than not closedgroup, showed that patients with surgical treatment in aperture yuexiaoyue closed easily.(4) not closed: injury after1month,6months,12months vision changes no statistical differences (he Chi Square test x2=2.00, P>2.00). Patients presented aperture at1486.50±381.64um,6months after injury in aperture at1379.84±412.43um,12months afterinjury in aperture at1389.91±413.75um, showed that after3monthsafter injury in pore size stability.三、Conservative treatment group (66.7%) is less than the surgicaltreatment of spontaneous closure rate set of closure rate (80%), butconservative treatment group patients vision increase rate (75%) thanthe surgical treatment group vision increase rate (62.5%).CONCLUSIONS:一、High in rate of spontaneous closure, closure time mostly in1~6months.二、After injury in patients with spontaneous closure, small in diameter is easy to be closed, big in diameter is not easy to close.三、In closing, vision improved. In not closed, the vision has noobvious change.四、Suggested that patients with traumatic macular hole can beconservative first observation of3~6months, if not closed should takesurgical treatment as soon as possible.