后巩膜加固术在高度近视治疗中的应用  

Application of posterior scleral reinforcement surgery in the treatment of high myopia

作　　者：吴家乐 熊朝晖 许寅聪 孙苗苗 高洁 Wu Jiale;Xiong Zhaohui;Xu Yincong;Sun Miaomiao;Gao Jie(Ophthalmology Department of the First Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第一医院眼科,石家庄050000

出　　处：《国际眼科纵览》2023年第6期517-523,共7页International Review of Ophthalmology

基　　金：河北省自然科学基金(H2021206198);2022政府资助优秀人才项目(LS202213)。

摘　　要：病理性近视最明显的特征是眼轴逐渐增长,出现后巩膜葡萄肿。后巩膜加固术是目前可以延缓或阻止眼轴延长治疗病理性近视的一种有效手术方式。手术机制主要是利用加固材料与自体巩膜发生炎性反应、新生血管生成及巩膜胶原纤维增生等病理改变来加强后极部薄弱的巩膜,防止眼轴长度的进一步增加。该手术方式在条带法、片式法、注射法的基础上改良出更多方法,目前仍以单条带加固法为主。后巩膜加固材料主要分为生物和非生物两类,各有利弊,目前以人工心包补片和异体巩膜为主。尽管后巩膜加固术在控制高度近视的发展中具有显著优势,但影像检查提示巩膜葡萄肿的形态及位置具有多样性,此手术难以符合手术机制,术后疗效存在争议。The most obvious feature of pathological myopia is the gradual increase of the eye axis and the appearance of posterior staphyloma.Posterior scleral reinforcement surgery is currently an effective surgical method for delaying or preventing axial elongation in the treatment of pathological myopia.It mainly uses reinforcement materials to cause inflammatory reactions,neovascularization,and collagen fiber proliferation in the sclera to strengthen the weak posterior sclera and prevent further increase in axial length.This surgical method has been improved on the basis of strip method,patch method,and injection method,and currently,single strip reinforcement method is still the main method.Posterior scleral reinforcement materials are mainly divided into two categories:biological and non-biological,each with its own advantages and disadvantages.Currently,artificial pericardial patches and allogeneic sclera are the main types.Although posterior scleral reinforcement surgery has significant advantages in controlling the development of high myopia,imaging examination suggests that the shape and location of staphyloma in the sclera are diverse,making it difficult for this surgery to conform to the surgical mechanism,leading to controversy over the postoperative efficacy.

关 键 词：高度近视 后巩膜加固术 加固材料 

分 类 号：R779.6[医药卫生—眼科]