大直径特发性黄斑裂孔的治疗现状及进展  

Progress of treatment for large idiopathic macular holes

作　　者：范小娥(综述) 任新军 李筱荣(审校)[1] Fan Xiaoe;Ren Xinjun;Li Xiaorong(Tianjin Medical University Eye Hospital,Eye Institute and School of Optometry,Tianjin Key Laboratory of Retinal Functions and Diseases,Tianjin International Joint Research Center of Ophthalmology and Visual Science,Tianjin 300384,China)

机构地区：[1]天津医科大学眼科医院,天津医科大学眼视光学院,天津医科大学眼科研究所,天津市视网膜功能与疾病重点实验室,天津市眼科学与视觉科学国际联合研究中心,300384

出　　处：《中华实验眼科杂志》2022年第1期88-92,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目(81600723)。

摘　　要：黄斑裂孔直径大小是影响其治疗效果的重要因素,直径>400μm者为大裂孔,玻璃体切除联合内界膜剥除、眼内填充能够有效地解除玻璃体视网膜界面的牵拉,是特发性全层黄斑裂孔(FTMH)手术治疗的经典方式。然而,对于大直经、复发性FTMH效果欠佳。为获得理想的大直径FTMH解剖愈合和功能恢复,新的手术治疗策略,如视网膜内界膜(ILM)翻转、扩大ILM撕除范围、不同组织瓣膜移植、间充质干细胞的应用等,一直是眼底病领域研究者探索和讨论的热点。更具针对性、个性化的治疗方案是大直径FTMH治疗的发展趋势。本研究就大直径FTMH的ILM翻转术、扩大范围的ILM剥除术,不同组织瓣膜移植术,生物材料等辅助技术等手术方式治疗进展进行综述。Size of the macular hole(MH)is an important factor affecting the treatment of MH.MH with a diameter>400 mm was defined as large MH.Pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)peeling or intravitreal gas tamponade,which can effectively relieve the traction of vitreoretinal interface,is the standard surgical technique for idiopathic full-thickness macular hole(FTMH),but its efficacy on refractory large FTMH is very limited.In order to obtain ideal anatomical healing and functional recovery of large FTMH,new surgical strategies,such as reversal of retinal internal limiting membrane(ILM),expanded removal of ILM,transplantation of different tissue valves,application of mesenchymal stem cells and so on,have been the focus of researchers in the field of fundus diseases.More targeted and personalized treatment is the development trend of treatment for large FTMH.The progress of ILM flipping surgery,expansion of ILM removal,transplantation of different tissue valves,biomaterials and other auxiliary techniques in the treatment of large diameter FTMH were reviewed in this article.

关 键 词：黄斑裂孔 手术 玻璃体视网膜手术 综述 

分 类 号：R779.6[医药卫生—眼科]