玻璃体手术后黄斑视网膜前膜形成的临床分析

Macular epiretinal membranes after vitrectomy

探讨玻璃体手术后黄斑视网膜前膜MacularEpiretinalMembranes (MEM )的形成时期、原因及对视功能的影响。方法 :回顾性分析了我院视网膜脱离患者 2 49例 ( 2 49眼 )行玻璃体视网膜复位手术后形成MEM的 5 1例 ( 5 1眼 )的临床资料 ,观察术后视力恢复及MEM形成情况 ,平均随访时间 4 82月。结果 :术后视力提高 34眼占 6 6 7% ,视力不变 10眼占 19 6 % ,视力下降 7眼占 13 7% ,视力于 12周后趋于稳定。MEM最早于术后 2周出现 ,随病程延长而明显增殖 ,于 8～ 12周达到高峰 ,12周后基本稳定。视网膜最终复位 48眼占 94 1%。结论 :玻璃体手术后MEM的形成是多种因素共同作用的结果 ,术前仔细检查玻璃体后脱离 (PosteriorVitreousDetachment ,PVD)状态 ,术中避免对视网膜过度损伤是防止术后MEM形成的关键 ;无论有无PVD ,部分病例均可发生MEM ,两者的病理机制及膜的超微结构有待于进一步观察。

Objective:To investigate the occurrence and visual acuity (VA) of macular epiretinal membranes (MEM) after vitrectomy. Methods:51 cases (51 eyes) of MEM in 249 cases (249 eyes) of vitrectomy were retrospectively reviewed.The time of onset and VA were analyzed.Mean time of follow-up is 4.82 months. Results:Postoperative final VA during follow up was improved in 34 eyes (66.7%),10 eyes (19.6%) unchanged,and 7 eyes (13.7%) reduced.The recovery of VA appeared to be long-standing after 12 weeks.MEM occurred in 2 weeks and proliferated along time after vitrectomy,its peek time ranged from 8 to 12 weeks and stable time after 12 weeks.48 eyes (94.1%) had retina reattachment. Conclusions:The formation of MEM occurs early in the second week and proliferated along time after vitrectomy.Whatever posterior vitreous detachment exit,MEM can present in some cases.