黄斑前膜手术疗效的观察和评价

Observation and Evaluation of the Curative Effect of Macular Epiretinal Membrane

目的通过对不同类型黄斑前膜的术后结果的分析,寻找黄斑前膜的最佳治疗方案。方法选取特发性黄斑前膜8例(8眼),继发性黄斑前膜18例(18眼),术前均行激光闪辉细胞仪(LFCM)检查、最佳矫正视力(BCVA)、光学相干断层扫描(OCT)检查、黄斑色素密度检查。所有患者均行23G玻璃体切割手术,分析黄斑前膜剥离术后BCVA、OCT、黄斑色素密度检查结果的变化和随访3个月的临床资料。结果两组患者术后视力较术前均提高,术后黄斑色素密度值较术前均有提高。18例继发性黄斑前膜患者的术后黄斑中心视网膜厚度与术前房水闪辉值呈正相关,并且术后BCVA与前房闪辉值呈负相关。结论特发性黄斑前膜是与年龄相关的机体退行性改变,出现临床症状即可行手术治疗。继发性黄斑前膜的形成涉及机体的炎症保护机制,不能盲目进行手术干预,应先行原发病的治疗,在炎症稳定期后适当的时机行手术治疗,减少术后并发症的发生。

Objective To analyse the postoperative results of different types of macular membrane and find the best treatment.Methods Eight cases of idiopathic macular membrane（ 8 eyes） and 18 cases of secondary macular membrane（ 18 eyes） were underwent aser flare cell meter（ LFCM） examination,best corrected visual acuity（ BCVA）,optical coherence tomography（ OCT） examination and macular pigment density checks before surgery. Results The postoperative visual acuity and the macular pigment of the two groups was improved,the thickness of macular in 18 patients with secondary macular membrane was positively correlated with the aqueous flare,and postoperative BCVA and anterior chamber flare values were negatively correlated. Conclusions Idiopathic macular membrane is the body＇s age-related degenerative changes,clinical symptoms is a feasible surgical treatment time. The secondary macular epiretinal membrane involves inflammation of the protective mechanism of the body,we should not intervene blindly,but should treat primary disease,and surgical treatment could be in stabilization period of inflammation,to reduce the incidence of postoperative complications.