关于黄斑裂孔手术中内界膜剥除及其衍生术式的思考  

Reflections on the inner limiting membrane peeling and its derivatives in macular hole surgery

作　　者：张美霞[1] 张韵 Zhang Meixia;Zhang Yun(Department of Ophthalmology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院眼科,成都610041

出　　处：《中华眼科杂志》2024年第3期220-225,共6页Chinese Journal of Ophthalmology

摘　　要：内界膜剥除是黄斑裂孔手术过程中的关键步骤,由此衍生改良的多种术式,如内界膜翻转覆盖、内界膜及其他组织填塞术、保留黄斑中心凹的内界膜剥除术等,均旨在提高黄斑裂孔的术后闭合率。黄斑裂孔手术的目的在于更好地保持黄斑中心凹结构的完整性,以求在解剖恢复的基础上尽可能达到功能恢复。但临床上存在为了单纯追求裂孔闭合率而过度选择某些手术方式的情况,这对患者视功能恢复并无益处。如何正确选择黄斑裂孔手术中内界膜及其衍生术式这一问题值得深度探讨。本文从临床实践应用结合国内外研究文献,针对这一临床焦点问题进行阐述,以供同行进行黄斑裂孔手术时参考。Internal limiting membrane(ILM)peeling is a critical step in the process of macular hole surgery,giving rise to various modified techniques such as ILM flip-over coverage,ILM and other tissue tamponade procedures,and foveal-sparing ILM peeling.All these approaches aim to improve the postoperative closure rate of macular holes.The goal of macular hole surgery is to better preserve the integrity of the foveal center structure,with the aim of achieving functional recovery on the basis of anatomical restoration.However,in clinical practice,there is a tendency to excessively choose certain surgical methods solely to pursue the closure rate of the hole,which may not be beneficial for the visual function recovery of the patients.This article discusses how to correctly select the internal limiting membrane and its derivative procedures in macular hole surgery,combining clinical practice and relevant domestic and international research literature.It aims to provide insights for colleagues performing macular hole surgery as a reference regarding this clinical focus issue.

关 键 词：视网膜外膜 视网膜穿孔 眼外科手术 

分 类 号：R779.6[医药卫生—眼科]