剥离内界膜的玻璃体切除术治疗高度近视黄斑裂孔性视网膜脱离

Vitrectomy with removal of internal limiting membrane to treat retina detachment caused by macular hole in highly myopic eyes

目的 评价剥离内界膜的玻璃体切除术治疗高度近视黄斑裂孔性视网膜脱离的临床疗效。方法 选择16例（16眼）高度近视黄斑裂孔性视网膜脱离患者，行常规经平坦部玻璃体切除、气-液交换、裂孔区注射透明质酸钠、吲哚菁绿染色、液-气交换、内界膜剥离、再次气-液交换、14％C3F8填充玻璃体腔，术后保持头低位，随访1～6个月。结果 16眼中，13眼黄斑裂孔愈合，视网膜复位，3眼裂孔未闭，其中1眼复发视网膜脱离；术后视力提高14眼，不变1眼，下降1眼。结论 剥离内界膜的玻璃体切除术能有效治疗高度近视黄斑裂孔性视网膜脱离，并能促进黄斑裂孔的愈合。

Objective To evaluate the clinical effect of vitrectomy with internal limiting membrane （ILM） peeling to treat retina detachment caused by macular hole in highly myopic eyes. Methods Sixteen highly myopic eyes with retina detachment caused by macular hole were conducted vitrectomy. During surgery, sodium hyaluronate were injected in the macular hole before dying with indocyanine green （ICG）. Peeld ILM, gas-liquid exchange and filled vitrous ＇with 14% C3F8 were carried out in routine sequences. Heads were kept down after surgery. The follow up duration was 1 month to 6 months. Results In all 16 eyes, macular hole of 13 eyes were closed and their retina were reattached, 3 eyes were not closed and 1 eye developed retina re-detached. Visual acuity was improved in 14 eyes, unchanced in 1 eye and decreased in 1 eye. Conclusion The surgery of vitrectomy with ILM peeling can effectively treat retina detachment caused by macular hole in highly myopic eyes and the macular hole can be closed by this surgery.