高度近视黄斑区玻璃体视网膜界面异常手术治疗中值得探讨的几个问题

Disputes revolved about surgeries of macular vitreoretinal interface abnormalities in highly myopic eyes

高度近视黄斑劈裂、黄斑裂孔等黄斑区玻璃体视网膜界面异常严重影响高度近视患者的视功能，其自然病程各异，手术治疗的关键是如何去除玻璃体后皮质对黄斑区视网膜的牵引，恢复黄斑中心凹原有的解剖结构，保持和（或）提高中心视功能。但玻璃体腔注气、后巩膜兜带和（或）加固、玻璃体切割手术等具体干预方式的选择和应用仍存在许多争议并值得探讨。如何正确理解和评价现有这些风格迥异的手术方式及其疗效，根据疾病的不同特点制定治疗方案是目前急需解决的现实问题。

Macular vitreoretinal interface abnormalities in highly myopic eyes are among the most vision-threatening diseases associated with macular retinal schisis and macular holes. To relieve the traction of the posterior vitreous cortex and to recover the anatomy of fovea for good central vision are the keys to successful repair. However, there are many controversial issues in the efficacy of the surgerical procedures including gas injection, scleral buckling and vitrectomy. How to evaluate these different surgeries and to establish standard surgical procedure options for macular vitreoretinal interface abnormalities in highly myopic eyes needs to be explored.