The comprehensive rehabilitative treatment was used in 58 cases(194 finger)for functional impairment after eplantation. After the treatment the overall increase of flexion-extension range of motion was 30 to 130 degrees respectively. From the assessment of 10 items of daily activities, the patients could accomplish three-fourth of them. the average time taken for the treatment was 3 months with an excellent-good rate about 87.4%. Through the early comprehensive rehabilititive treatment patients could achieve better results.
ObjectiveTo compare the efficacy of pars plana vitrectomy (PPV) combined inverted internal limiting membrane (ILM) with PPV combined ILM peeling for macular hole retinal detachment (MHRD) in high myopia.MethodsA retrospective clinical study. From October 2012 to January 2019, 78 patients (78 eyes) with high myopia macular hole retinal detachment diagnosed from Chongqing Aier Eye Hospital and Hefei Aier Eye Hospital were included in the study. Among them, there were 11 males (11 eyes) and 67 females (67 eyes) with the average age of 55.6±9.6 years. All patients underwent BCVA, diopter, OCT examination and axial length (AL) measurement. The standard logarithmic visual acuity chart was used for BCVA examination, and the visual acuity was converted to logMAR when recorded. Patients were divided into PPV combined with ILM peeling group (ILM peeling group) and PPV combined with ILM inverted group (ILM inverted group) according to the surgical method, with 51 patients (51 eyes) and 27 patients (27 eyes), respectively. The average age (t=－1.170), diopter (t=0.504), AL (t=0.474), logMAR BCVA (t=0.935), and hole diameter (t=－0.334) of the two groups were compared, and there was no statistically significant difference (P＞0.05). Two independent sample t test was used to compare the exposed distance of BCVA and RPE before and after the operation of the two groups of eyes. The χ2 test was used to compare the rates between the two groups.ResultsAt the last follow-up, the logMAR BCVA of the eyes in the ILM inverted group and ILM peeling group were 0.87±0.27 and 1.45±0.39, respectively. Compared with pre-operation, the BCVA of the two groups of eyes were significantly improved, and the difference was statistically significant (t=8.790, 4.640, P＜0.001,＜0.001). The logMAR BCVA of the two groups of eyes was compared with statistical significance (t=6.830, P＜0.001). The exposed RPE distances of the eyes in the ILM inverted group and the inner limiting membrane peeling group were 31.81±23.52 and 681.80±466.61 μm, respectively. the difference in the RPE exposure distance between the two groups was statistically significant (t=7.180, P＜0.001). The holes in the 27 eyes in the ILM inverted group were healed (100%, 27/27); no retinal detachment occurred. Among the 51 eyes in the ILM peeling group, the hole healed in 45 eyes (88.2%, 45/51), and the retina was detached in 6 eyes (11.8%, 6/51). There was a statistically significant difference in the incidence of retinal detachment between the two groups of patients (χ2=45.440, P=0.000).ConclusionCompared to ILM peeling, inverted ILM has provided better RPE protection and reduce the rate of retinal redetachment in patients with MHRD.