内界膜剥除术并发症的研究

Study on complications of internal limiting membrane peeling

内界膜剥除术现已广泛应用于玻璃体视网膜疾病,如特发性黄斑裂孔、黄斑前膜、黄斑水肿、外伤性视网膜病变、视网膜劈裂、视盘小凹等的治疗中,尤其是黄斑部疾病。由于对内界膜的生理功能的重视,目前对于上述疾病玻璃体切除术中内界膜是否剥除、剥除的面积及方式等仍然存在争议。已有文献报道内界膜剥除主要并发症有:对内层视网膜结构的影响,对视网膜及脉络膜血流的影响,对视网膜电活动的影响,染色剂潜在的视网膜毒性,黄斑区解剖结构的改变,视野改变和对视力的潜在损害。因此,该文对黄斑裂孔及黄斑前膜手术治疗中内界膜剥除术的并发症进行综述。

Internal limiting membrane peeling is now widely used in the treatment of vitreoretinal diseases, such as idiopathic macular hole, epiretinal membrane, macular edema, traumatic retinopathy, retinoschisis, and optic pit, especially macular diseases. Due to the attention paid to the physiological function of the internal limiting membrane, there is still controversies about whether the internal limiting membrane is removed, and the area and the way of the removal in vitrectomy of the above diseases. Major complications have been reported in literature： effects on internal retinal structure, retinal and choroidal blood flow, retinal electrical activity, potential retinal toxicity of stain, changes in the anatomy of macular area, changes in visual field and potential damage to vision. In this paper, we reviewes the complications of internal limiting membrane peeling in the treatment of macular hole and epiretinal macular membrane.