玻璃体切除联合内界膜剥离预防复杂性视网膜脱离术后黄斑前膜形成

目的 观察一组复杂性视网膜脱离患者在玻璃体切除手术时联合黄斑部内界膜剥离而预防术后黄斑前膜形成的临床疗效.方法 取2006年1月至2008年10月42例(42只眼)复杂性视网膜脱离(complicated retinal detachment,CRD)患者接受玻璃体切除术治疗,将其分为两组:玻璃体切除联合内界膜剥离组20例20只眼(Ⅰ组),玻璃体切除未行内界膜剥离组22例22只眼(Ⅱ组),术后随防12～26个月,平均随访时间(18±8)个月.结果 Ⅰ组在硅油取出后随访未发现黄斑前膜形成;Ⅱ组在硅油取出后有6眼经OCT和(或)FFA检查证实有黄斑前膜形成,其中2只眼在硅油未取出前经OCT和(或)FFA检查发现就有黄斑前膜形成.结论 复杂性视网膜脱离患者玻璃体切除手术时联合黄斑部内界膜剥离可以预防术后黄斑前膜的形成.

Abstract：

Objective To investigate the clinical effect of internal limiting membrane (ILM) peeling at the macular for the prevention of epimacular membrane formation following vitreous surgery for the treatment of complicated retinal detachment. Methods From February 2006 to October 2008, 42 patients with complicated retinal detachment were underwent successful vitrectomy. According to ILM peeling or not during vitrectomy, all patients were divided into two groups: the group Ⅰ (peeling ILM) 20 eyes, the group Ⅱ (not-peeling ILM) 22 eyes, followed up for 12-26 months, mean at 18± 8 months. All of those were examined for visual acuity, fundus photography, ophthalmologic A/B ultrasonic imaging, OCT preoperatively and postoperatively,the parts of those were examined for FFA postoperatively. The epimacular membrane formation was decided by the last chance at one year to two years after removal of silicone. The epimacular membrane formation of two groups was analyzed statistically. Results No epimacular membrane formation was seen in group Ⅰ . The epimacular membrane formation of two eyes was verified by OCT or/and FFA before removal of silicone, and the epimacular membrane formation of four eyes was verified by OCT or/and FFA after removal of silicone.The comparison of epimacular membrane formation between group Ⅰ and group Ⅱ was statistically significant.Conclusion ILM peeling at the macular during vitreous surgery for the treatment of complicated retinal detachment may effectively prevent epimacular membrane formation.

Peeling off internal limiting membrane during vitrectomy for complicated retinal detachment prevents epimacular membrane formation

Objective To investigate the clinical effect of internal limiting membrane (ILM) peeling at the macular for the prevention of epimacular membrane formation following vitreous surgery for the treatment of complicated retinal detachment. Methods From February 2006 to October 2008, 42 patients with complicated retinal detachment were underwent successful vitrectomy. According to ILM peeling or not during vitrectomy, all patients were divided into two groups: the group Ⅰ (peeling ILM) 20 eyes, the group Ⅱ (not-peeling ILM) 22 eyes, followed up for 12-26 months, mean at 18± 8 months. All of those were examined for visual acuity, fundus photography, ophthalmologic A/B ultrasonic imaging, OCT preoperatively and postoperatively,the parts of those were examined for FFA postoperatively. The epimacular membrane formation was decided by the last chance at one year to two years after removal of silicone. The epimacular membrane formation of two groups was analyzed statistically. Results No epimacular membrane formation was seen in group Ⅰ . The epimacular membrane formation of two eyes was verified by OCT or/and FFA before removal of silicone, and the epimacular membrane formation of four eyes was verified by OCT or/and FFA after removal of silicone.The comparison of epimacular membrane formation between group Ⅰ and group Ⅱ was statistically significant.Conclusion ILM peeling at the macular during vitreous surgery for the treatment of complicated retinal detachment may effectively prevent epimacular membrane formation.