高度近视黄斑裂孔性视网膜脱离的玻璃体视网膜手术治疗进展  

Development of vitreoretinal surgery for macular hole retinal detachment in high myopic eyes

作　　者：陈松[1] 田歌 何广辉[1] CHEN Song;TIAN Ge;HE Guanghui(The Clinical College of Ophthalmology of Tianjin Medical University,Tianjin Eye Hospital,Tianjin Key lab of Ophthalmology and Visual Science,Tianjin Institute of Ophthalmology,Tianjin 300020,China)

机构地区：[1]天津医科大学眼科临床学院,天津市眼科医院,天津市眼科学与视觉科学重点实验室,天津市眼科研究所,天津市300200

出　　处：《眼科新进展》2020年第10期994-1000,共7页Recent Advances in Ophthalmology

摘　　要：黄斑裂孔性视网膜脱离(macular hole retinal detachment,MHRD)是高度近视眼常见的并发症,常造成不可逆的视力损害。玻璃体视网膜手术(vitreoretinal surgery,VRS)是MHRD的主要治疗方式,但是由于此类患者伴有视网膜脉络膜萎缩、后巩膜葡萄肿、眼轴增长等异常解剖结构,故手术难度大、患者视力预后差,易复发。近年来,随着眼内填充物选择的多样化、内界膜处理技巧的发展以及眼科机器人等新技术的兴起,VRS治疗高度近视MHRD取得了令人满意的视网膜解剖复位率。如何在提高视网膜复位率及黄斑裂孔闭合率的基础上实现患者视功能的改善是目前VRS治疗高度近视MHRD的重点与难点。本文现就高度近视MHRD的VRS治疗进展进行综述。Macular hole retinal detachment(MHRD)is a common complication of high myopia,which often causes irreversible visual impairment.Vitreoretinal surgery(VRS)is the primary treatment of MHRD.However,the abnormal anatomical structure of the patient with MHRD,such as choroidal atrophy,posterior scleral staphyloma,and axial growth,bring difficulties to the surgery,resulting that the postoperative visual prognosis is weak,and the recurrence rate is high.In recent years,with the diversity of intraocular filler selection,the development of processing techniques for internal limiting membrane and the rise of robotic eye surgery,the retinal anatomical reduction rate is satisfactory with VRS for MHRD.How to improve the visual function of patients based on improvement of retinal reattachment rate and macular hole closure rate is the focus and difficulty of VRS for MHRD in high myopic eyes.This paper will give a review on VPS for MHRD in high myopic patients.

关 键 词：近视 视网膜脱离 黄斑裂孔 玻璃体视网膜手术 内界膜 

分 类 号：R774.1[医药卫生—眼科]