玻璃体切除联合膜剥离术治疗特发性黄斑前膜的效果  

The efficacy of vitrectomy combined with membrane peeling for the treatment of idiopathic epiretinal membrane

作　　者：宋殊琪 巩琰[2] 郝晓璐[2] 姚毅[2] 

机构地区：[1]武警北京总队第二医院眼科,北京100037 [2]解放军总医院眼科,北京100853

出　　处：《中华眼外伤职业眼病杂志》2017年第5期342-347,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价25G玻璃体切除联合膜剥离术治疗特发性黄斑前膜的临床效果。方法对特发性黄斑前膜23例（23只眼）的临床资料进行回顾性分析。结果术后19只眼视力提高，4只眼视力不变，无视力下降者。11只眼术前视物变形者中，术后9只眼视物变形减轻，但未完全消失。根据特发性黄斑前膜的不同形态分为4组：黄斑前膜并发黄斑水肿组14只眼，均行玻璃体切除及膜剥除术，术中7只眼联合视网膜内界膜剥除术，术后12只眼视力提高，2只眼视力不变。增生型黄斑前膜组6只眼，1只眼单纯行黄斑前膜剥除术，5只眼玻璃体切除及膜剥除术，术中2只眼联合视网膜内界膜剥除术，术后4只眼视力提高，2只眼视力不变。黄斑前膜引起黄斑假孔组2只眼，均行玻璃体切除及膜剥除术，术后视力均提高。黄斑前膜引起黄斑板层孔组1只眼，行玻璃体切除及膜剥除术，术中联合视网膜内界膜剥除，术后视力提高。结论玻璃体切除联合膜剥离术治疗特发性黄斑前膜有效。Objective To evaluate the efficacy of 25-gauge vitrectomy combined with membrane peeling for the treatment of idiopathic macular epiretinal membrane. Methods The clinical data of 23 eyes of 23 patients with idiopathic macular epiretinal membrane were analyzed retrospectively. Results The visual acuity after surgery was improved in 19 eyes, and unchanged in 4 eyes. Before surgery the metamorphopsia was in 11 eyes, among them the metamorphopsia relieved, but did not completely disappeared in 9 eyes. According to the different forms of idiopathic epiretinal membrane, these patients were divided into 4 groups： the group of epiretinal membrane associated with macular edema, 14 eyes, underwent vitrectomy combined with membrane peeling, there were 7 eyes with retinal internal limiting membrane peeling during surgery; after surgery, the visual acuity improved in 12 eyes, and remained unchanged in 2 eyes. The group of proliferative epiretinal membrane, 6 eyes, among them 1 eye treated with epiretinal membrane peeling only. The other 5 eyes received vitrectomy combined with membrane peeling, during surgery 2 eyes combined with ILM peeling, the visual acuity improved in 4 eyes and unchanged in 2 eyes after operation. The group of macular pseudohole induced by macular epiretinal membrane, 2 eyes, underwent vitrectomy combined with membrane peeling, the vision acuity improved in all cases after surgery. The group of lamellar macular hole leaded by epiretinal membrane, 1 eye, underwent comined surgery with ILM peeling, the postoperative visual acuity improved. Conclusion Vitrectomy combined membrane peeling can effectively treat for idiopathic macular membrane.

关 键 词：黄斑前膜 特发性 玻璃体切除术 联合膜剥除术 

分 类 号：R779.6[医药卫生—眼科]