摘要
难治性黄斑裂孔（MH）是指常规玻璃体切割、内界膜（ILM）和前膜剥除、眼内填充和手术后俯卧位等手术方法难以使MH闭合且预后相对较差的MH，主要包括大直径MH、高度近视MH、外伤性MH、既往手术后MH不能闭合或是MH再开放、继发性MH等。针对难治性MH的手术治疗进展主要包括ILM翻瓣手术、自体ILM移植手术、MH内视网膜色素上皮激光光凝、扩大ILM撕除范围、弓形视网膜切开松解手术、自体晶状体囊膜移植手术以及间充质干细胞移植等。各种治疗干预方式中，松解MH周围牵拉、提供Muller细胞增生支架和促进光感受器功能恢复是需要关注研究的重点；生物黏合剂、干细胞移植、组织工程视网膜移植等可能是未来值得期待的治疗手段。
Refractory macular hole （MH） has lower surgical anatomical closure rate and poor recovery of visual acuity due to its clinical characteristics. Refractory macular hole includes unclosed MH, reopening MH, large MH, high myopic MH, traumatic MH and secondary MH. Some modified surgeries were employed to improve the surgical results. Inverted internal limiting membrane flap, autologous transplantation of the internal limiting membrane, laser photocoagulation, extended internal limiting membrane peeling, arcuate retinotomy, lens capsular flap transplantation and mesenchymal stem cell transplantation can improve the prognosis partially. Loosening MH traction, providing a scaffold for Muller cell proliferation and promoting photoreceptor reconstruction will. be the key points in future.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2016年第5期553-556,共4页
Chinese Journal of Ocular Fundus Diseases
