玻璃体手术治疗黄斑孔性视网膜脱离的初步报告

Preliminary report of vitreous surgery on retinal detachment caused by macular hole.

本文对15例伴有玻璃体视网膜异常粘连的黄斑孔性视网膜脱离进行了玻璃体切除、视网膜前膜剥离、玻璃体注惰性气体及巩膜扣带术.术中重点在于玻璃体后界膜的分离.追踪观察6～12个月,视网膜解剖及功能复位率为93.3%.根据术中所见,本文提出针对其发病机制进行有目的、有选择的治疗方案,同时注意到玻璃体后界膜对黄斑孔的形成、视网膜脱离的发生,以及增殖性玻璃体视网膜病变中的决定性作用.

Fifteen cases of retinal detachment caused by macular hole with the abnormal vitreoretinal adhesion were treated by vitrectomy, membrane peeling, gas injection and scleral buckling. The surgery was focused on the separation of posterior vitreous membrane from the retina. Following up 6~ 12 months, the re-attachment rate of the retina was 93.3% anatomically and functionally. According to the observation during the surgery, we assumed that the management should follow the mechanism and noticed that the posterior vitreous membrane may play a decisive role in forming macular hole, developing retinal detachment, and in the proliferative vitreoretinopathy.