视网膜脱离视网膜下膜的手术治疗和电镜观察  

Surgical treatment and electron microscope observation on subretinal membranes in retinal detachments

作　　者：方巧琳 杨安怀[1] FANG Qiaolin;YANG Anhuai(Eye Center,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院眼科中心,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2022年第5期822-825,共4页Medical Journal of Wuhan University

摘　　要：目的:研究视网膜脱离视网膜下膜的手术方式选择及电镜下组织结构的观察。方法:对2017年1月至2020年9月在武汉大学人民医院确诊视网膜脱离伴视网膜下膜,行玻璃体切除或巩膜外加压术的患者71例71只眼纳入研究,其中增殖较轻的47例,根据眼底情况分别行巩膜外加压术(A组)10眼,玻璃体切除术(B组)37只眼,视网膜下增殖较重的24只眼行玻璃体切除术取出视网膜下膜(C组),并对手术切除的视网膜下膜进行电镜下的观察。结果:术后随访1年,A组复发视网膜脱离1眼(1/10,10.00%),B组4眼(4/37,10.81%),C组2眼(2/24,8.33%),3组间复发率无明显差异(P=1.000)。结论:轻度的视网膜下增殖可不处理,只有当视网膜下膜影响裂孔闭合和视网膜复位时,才需要切除,解除牵拉。Objective: To evaluate the choices of surgeries of subretinal membrane in retinal detachment and the observation of tissue structure under electron microscope. Methods: A total of 71 eyes of 71 patients with retinal detachment and subretinal membrane diagnosed in Renmin Hospital of Wuhan University from January 2017 to September 2020 who underwent successful vitrectomy or scleral buckling were included in the study. Among them, 47 patients with mild proliferation received scleral buckling(group A) in 10 eyes and vitrectomy(group B) in 37 eyes according to the fundus performance, respectively. The subretinal membrane(subretinal membrane) was removed from 24 eyes with severe proliferation(group C) and observed under electron microscope. Results: At the postoperative follow-up of one year, retinal detachment occurred in 1 eye(1/10, 10. 00%) of 10 eyes in group A, 4 eyes(4/37,10. 81%) of 37 eyes in group B and 2 eyes(2/24, 8. 33%) of 24 eyes in group C. There was no significant difference in the recurrence rate among the three groups(P=1. 000). Conclusion: Mild subretinal proliferation may not have to remove, and only when the subretinal membrane interferes with the close of retinal hole and retinal reattachment should be removed.

关 键 词：视网膜下膜 视网膜脱离 视网膜切开 视网膜下膜切除 

分 类 号：R774.1[医药卫生—眼科]