内界膜剥除术治疗近视性牵引性黄斑病变的研究进展

Advances of internal limiting membrane peeling in the treatment of myopic traction maculopathy

内界膜(internal limiting membrane)位于视网膜神经上皮最内层,是Müller细胞的基底膜,在近视性视网膜病变中对视网膜形成向前的牵引力,引起近视性牵引性黄斑病变(myopic traction maculopathy,MTM)。在以往的临床研究中对MTM疾病进行经睫状体平坦部玻璃体切除手术(pars plana vitrectomy,PPV)时,对内界膜有相应的处理,包括内界膜剥除、翻转、填塞等,不同的处理方式视网膜的复位率,黄斑孔的闭合率以及视力提高程度不同。本文就发生MTM时内界膜病理性改变,及行玻璃体切除手术治疗时对内界膜不同处理方式进行综述。

The internal limiting membrane(ILM)is located in the innermost layer of the retinal neuroepithelium,which is the basement membrane of Müller cells.In myopic retinopathy,ILM forms forward traction to the retina and causes the myopic traction maculopathy(MTM).In previous clinical studies,MTM is treated with pars plana vitrectomy(PPV)combined with ILM peeling,reversal and tamping,etc.The rate of retinal reattachment,macular hole closure and visual acuity improvement are different in different treatments.In this paper the pathological changes of the ILM in MTM,and the treatment methods of ILM during vitrectomy will be reviewed.