特发性黄斑裂孔玻璃体切除术后俯卧位有必要吗?

Necessity of face-down position after vitrectomy for idiopathic macular hole

特发性黄斑裂孔是中老年女性中心视力丧失的较常见原因。玻璃体切除术联合气体填充是目前标准的治疗方式。解除黄斑中心凹前后以及切线方向的牵拉是手术成功治疗的关键。眼内填充物也经历了从硅油到长效气体(C3F8、C2F6),再到中、短效气体(SF6、空气)的演变历程。采用更短效气体且术后不用俯卧位可能是未来的研究趋势。最大程度恢复黄斑区的形态功能和改善患者围手术期生活质量是治疗特发性黄斑裂孔的最终目标。采用非手术的方式促进裂孔闭合、恢复视功能可能是未来的发展方向。(眼科,2013,22:361-363)

Idiopathic macular hole （IMH） is a full-thickness defect of retinal tissue involving the anatomic fovea and is the com- mon cause of vision decrease among elderly women. Pars plana vitrectomy combined with gas tamponade is the standard treatment for IMH. Removal tangential or anteroposterior vitreofoveal traction is the key point to close IMH successfully. Tamponade agents have al- ready evolved from silicon oil and long-acting gas （C3F8/C2F6） to short-acting gas （SF6/air）. Filling with a more short-acting gas and al- leviated face-down position may be the trend in future. It is the ultimate goal for treating IMH to recover the morphology and function of macula maximally and to improve the quality of life. To promote IMH closure spontaneously and restore visual function completely by non-surgical intervention may be the future direction.