吲哚青绿和黏弹剂混合物在特发性黄斑裂孔手术中应用

Application of the mixture ofindocyanine green and viscoelastic during macular holes surgery

目的探讨可降低吲哚青绿着染内界膜对视网膜及视神经毒性的一种新方法。方法对2008年6月至2009年3月诊断为特发性黄斑裂孔并行玻璃体切割联合视网膜内界膜剥除术的12例12只眼，采用常规经睫状体平坦部三通道玻璃体切割、内界膜剥除、联合C2F6填充术，术中应用0．1％吲哚青绿和黏弹剂的混合物染色内界膜。结果术后随访6-15个月，2只眼（17％）黄斑裂孔孔径缩小未完全闭合，10只眼（83％）黄斑裂孔完全闭合，10只眼（83％）术后视力提高，9只眼视物变形消失，3只眼视物变形改善。所有患者均无黄斑裂孔区视网膜色素上皮萎缩，无视神经萎缩及无视野损害。结论此手术方法可有效地降低吲哚氰绿对黄斑裂孔附近视网膜以及视神经的毒性。

Objective To investigate a new surgery technique of reducing the toxic effect of indocyanine green on retina and optic nerve when assisted internal limiting membrane （ILM） peeling. Methods Twelve eyes of 12 patients with IMH underwent vitrectomy combined with ILM peeling during the period of June 2008 to March 2009 were enrolled. All patients underwent a routine three-port pars plana vitrectomy, ILM peeling and C2F6 tamponade. The mixture of 0.1% indocyanine green and viscoelastic was applied to stain ILM.3 of the eyes underwent cataract surgery. Results The postoperative follow-up ranged 6 to 15 months. In 2 eyes （17%） the MH was narrow but not closed completely, and in the rest eyes （83%） the MH was closed completely. There was improvement of visual acuity in 10 eyes （83%）. The symptom ofdysmorphopsia disappeared in 9 eyes and relieved in 3 eyes. Neither atrophic RPE changes in the area of the previous MH, nor optic atrophy or visual field defect were observed in any eyes. Conclusions This surgery technique can effectively reduce the toxic effect of ICG on the retina around the MH and optic nerve.