重视病理性近视眼牵拉性黄斑病变玻璃体手术时机及术式选择  

Emphasizing the timing and procedure selection for vitrectomy in pathological myopic traction maculopathy

作　　者：魏文斌 邵蕾 周文达 Wei Wenbin;Shao Lei;Zhou Wenda(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology&Visual Sciences,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心、北京市眼科研究所、北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《中华眼科杂志》2024年第3期211-214,共4页Chinese Journal of Ophthalmology

摘　　要：黄斑病变是导致病理性近视眼患者不可逆视力损伤的主要原因,其中牵拉性黄斑病变常需要玻璃体手术治疗。牵拉性黄斑病变包括黄斑前膜、黄斑劈裂、黄斑裂孔及黄斑裂孔性视网膜脱离等。建议对Ⅱ型黄斑前膜行玻璃体切除联合内界膜剥离术,对黄斑劈裂行保留黄斑中心凹的内界膜剥离术,对黄斑裂孔行内界膜瓣填充术,对难治性黄斑裂孔性视网膜脱离行玻璃体切除联合黄斑兜带术治疗。病理性近视眼牵拉性黄斑病变是一种慢性发展性疾病,术者要准确把握手术时机,选择合适的术式使患者得到的收益最大化。Myopic maculopathy is the primary cause of irreversible visual impairment in patients with pathologic myopia,and myopic traction maculopathy often requires vitrectomy for treatment.Myopic traction maculopathy encompasses epiretinal membrane,foveoschisis,macular hole,and macular hole-related retinal detachment.It is recommended to perform vitrectomy combined with inner limiting membrane peeling for Type II epiretinal membrane,foveal-sparing inner limiting membrane peeling for foveoschisis,inverted inner limiting membrane flap technique for macular hole,and vitrectomy combined with macular buckle for refractory macular hole-related retinal detachment.Myopic traction maculopathy is a chronically progressive condition,and surgeons need to accurately determine the timing of surgery and choose appropriate procedures to maximize the benefits for patients.

关 键 词：近视 退行性 黄斑变性 玻璃体切除术 内界膜剥离术 手术时间 

分 类 号：R779.6[医药卫生—眼科]