黄斑前膜手术疗效分析

The analyse of the effect in macular preretinal membrane surgery

目的探讨玻璃体切除联合黄斑前膜剥离治疗黄斑前膜手术疗效。方法回顾分析45例黄斑前膜手术治疗前后视功能改变及手术并发症。结果随访3～10个月，45例（45眼）中特发性黄斑前膜23眼中，术前视力低于0．3者15眼（65．2％），0．3及以上者8眼（34．8％）；术后视力低于0．3者9眼（39．1％），0．3及以上者14眼（60．9％）。继发性黄斑前膜22眼中，术前视力低于0．05者18眼（81．9％），术后为12眼（54．6％）；术前0．05及以上者4眼（18．1％），术后10眼（45．4％）。两组术后视力改善。视物变形消失者占37．5％，其余患者视物变形症状明显改善。黄斑孔2眼为其手术严重并发症。结论玻璃体切除联合黄斑前膜剥离是黄斑前膜有效的治疗方法。

Objective To study the effect of surgery on macular epiretinal membrane by vitrectomy with inner limiting membrane peeling. Methods The changes in visual function and complications of sur- gery in 45 cases with macular preretinal membrane before and after surgery were analysed. Results Fol- lowed up 3 - 10 months, 45 cases（45 eyes） included idiopathic macular epiretinal membrane in 23 eyes and secondary epimacular membrane in 22 eyes. In 23 eyes with idiopathic macular epiretinal membrane, preop- erative visual acuity was less than 0.3 in 15 eyes （65.2%） , better than or equal to 0. 3 in 8 eyes （34.8%） ;postoperative visual acuity was less than 0.3 in 9 eyes（39.1% ）, better than or equal to 0.3 in 14 eyes （60.9%）. In 22 eyes with secondary macular epiretinal membrane, preoperative visual acuity was less than O. 05 in 18 eyes（81.9% ） , postoperative in 12 eyes（54.6% ） ; preoperative was better than or e- qual to 0.05 in 4 eyes （ 18.1% ） , postoperative in 10 eyes（45.4% ）. The postoperative visual acuity im- proved in both groups. Metamorphosia disappeared in 37.5% , improved in remainder. The serious complica- tions of the surgery included macular hole in 2 eyes. Conclusion Vitrectomy with inner limiting membrane peeling is effective treatment for macular epiretinal membrane.