重视视网膜手术后的黄斑功能和视觉质量

To improve the macular function and visual quality after vitreoretinal surgeries

黄斑裂孔（MH）和孔源性视网膜脱离手术是眼底病外科医生最常见和最基本的手术.无论是玻璃体切割、内界膜剥除的黄斑手术,还是局部巩膜外加压、巩膜扣带的单纯视网膜手术,其成功率均已达95.0％以上.尽管如此,这两类手术后患者视功能的恢复仍不尽如人意.视网膜手术后黄斑功能和视觉质量问题仍值得重视.MH手术和巩膜手术后黄斑解剖和功能恢复需要一个过程.MH手术后视功能的恢复与裂孔是否闭合、是否微创、剥膜技巧、染色剂使用、眼内填充物选择等影响因素有关;巩膜手术视网膜复位后视功能恢复主要与黄斑区视网膜下积液残存有关.探讨影响黄斑功能和视觉质量的相关因素,研究针对这些影响因素的干预措施,特别是期望能有药物对黄斑损伤修复进行干预,重建黄斑部视网膜解剖结构和功能是这一研究领域当今和未来研究的重点和方向.

Surgical treatments for macular hole and rhegmatogenous retinal detachment are the most common and principle procedures for vitreoretinal specialists.The surgical success rate reached 95.0％ and above for vitrectomy,macular surgeries with ILM peeling,or local/total scleral buckling.However,the postoperative visual function recovery is nowhere near good enough.Specialists must pay more attention to the visual function recovery of those patients.Postoperative macular anatomical and functional rehabilitation for macular hole and scleral buckling procedures need a long period of time.At present,the postoperative visual acuity for macular hole depends on many factors,such as macular hole closure conditions,surgical procedures,microsurgical invasive ways,skills of membrane peeling,usage of dye staining,and tamponade material choice.It also depends on residual subretinal fluid under macular area for patients received scleral buckling.It is important for us to investigate these factors affecting recovery of macular anatomy and function,and thus develop some drugs to improve the macular function recovery.