吲哚青绿辅助视网膜内界膜剥离治疗特发性黄斑裂孔

目的 探讨玻璃体切割，吲哚青绿（indocyanine green,ICG）辅助视网膜内界膜剥离治疗特发性黄斑裂孔的手术疗效。 方法 31例患者（31只眼）为3期(14只眼，占45.2%)和4期(17只眼，占54.8%)特发性黄斑裂孔，所有患者均行玻璃体切割术，玻璃体腔注入1.25 mg/ml ICG，剥离裂孔周围2～3个视盘直径的内界膜，手术结束时充填14%的C-3F-8混合气体，手术后患者俯卧位2周,手术后平 均随访9.1个月。 结果 31例患者(31只眼) 手术前视力中位数(M)是20/200。手术后最终随访28只眼解剖复位，21只眼视力提高2行以上，除1只眼因视网膜周边裂孔，视网膜脱离外，ICG辅助的内界膜剥离无明显并发症。 结论 ICG辅助视网膜内界膜剥离治疗3～4期特发性黄斑裂孔安全有效。 （中华眼底病杂志，2003，19：137-140）

The treatment of indocyanine-green-assisted internal limiting membrane peeling for idiopathic macular hole

Objective To determine the anatomical and visual outcome of indocyanine-green (ICG)-assisted internal limiting membrane (ILM) peeling for idiopathic macular holes. Methods Thirty-one eyes of 31 patients with 3- (14 eyes, 45.2%) and 4-staged (17 eyes, 54.8%) primary idiopathic macular holes were analyzed. All the patients underwent the subtotal pars plana vitrectomy with removal of the posterior vitreous. ICG solution with the concentration of 1.25 mg/ml was injected into vitreous cavity. The ILM was stained and removed in a circular fashion of 2 to 3 disc-diameter from the edge of the hole. At the end of the surgery, 14% C 3F 8 mixed gas was used and the patients were required to maintain a prostrate posture for two weeks postoperatively. The mean follow-up duration was 9.1 months. Results The preoperative median visual acuity was 20/200. In the final follow-up, 28 eyes (90.3%) had anatomical restoration of the macular holes, 21 eyes had improvement of two lines or more of visual acuity. There was no direct complication or toxicity related to ICG-assisted ILM peeling except one patient with retinal detachment caused by peripheral retinal hole. Conclusion ICG-assisted retinal ILM removal appears beneficial and safe for primary idiopathic 3 and 4-staged macular holes.