眼外伤玻璃体切除术后发生的黄斑视网膜前膜的分析

Analysis of macular epiretinal membrane formation after pars plana vitrectomy for ocular trauma

目的 分析眼外伤及视网膜脱离等患者玻璃体切除术后发生的黄斑区视网膜前膜的临床特征.方法 2014年2月至2016年1月我院眼二科眼底病专业第2治疗组进行此种玻璃体切除术随访3个月以上者1498例（1536只眼）,其中55例（58只眼,占3.78％）术后发生了黄斑前膜.对患者年龄、原发病种及黄斑前膜发生时间进行回顾分析.结果 2 ～ 20岁年龄组中发生黄斑前膜者20只眼,占本年龄组164只眼的12.20％;21 ～40岁组17只眼占本组的3.37％;41 ～60岁组13只眼占本组的2.28％;61 ～76岁组8只眼占本组的2.67％.眼外伤眼发生黄斑前膜者35只眼占眼外伤318眼的11.01％;孔源性视网膜脱离组（RRD） 15只眼占3.33％;玻璃体积血组2只眼占4.35％;增生性糖尿病视网膜病变组6只眼占1.21％.将眼外伤及RRD合为一组,余为另一组,采用卡方检验,黄斑前膜发生率差异有统计学意义（x2=10.113,P＜0.001）.眼外伤及RRD出现黄斑区视网膜前膜的时间分别为术后（55.23±4.70）d、（62.83±3.25）d.结论 玻璃体切除术后黄斑前膜易在眼外伤及RRD组中及年轻患者中出现,时间为术后两个月左右.

Objective To analyse the clinical features of macular epiretinal membrane （MEM） formation after pars plana vitrectomy （PPV） of patients with ocular trauma,rhegmatogenous retinal detachment（RRD）,etc.Methods A retrospective analysis was taken in 1536 eyes of 1498 cases who underwent vitrectomy from Feb.2014 to Jan.2016.The MEM developed after the PPV（3.78%）in 58 eyes.The relationship between the age,the cause and the duration of the MEM was analyzed.Results There were 20 eyes in 2-20 years of age group （12.20%）,17 eyes in 21-40 years group （3.37%）,13 eyes in 41-60 years group（2.28%）,8 eyes in 61-76 years group（2.67%）.There were 35 eyes in ocular trauma group（11.01%）,15 eyes in RRD group（3.33%）,2 eyes in vitreous hemorrhage group（4.35%）,6 eyes in proliferative diabetic retinopathy group（1.21%）.If the ocular trauma and RRD merged into one group,and the remaining groups merged into another group,the difference between this two groups was statistically significant（x2 =10.113,P 〈0.001）.The average occurrence time of ocular trauma group and RRD group were （55.23 ± 4.70） days and （62.83 ±3.25） days,respectively.Conclusion The MEM after PPV to occurs easily in young patients who have ocular trauma or RRD.It happened about two months time after surgery.