黄斑外加压手术的指征与挑战

Indications and challenges of episcleral pressurization of macula

病理性近视是以眼轴进行性延长、后巩膜葡萄肿形成为特征, 伴随视网膜脉络膜不可逆性退行性变, 是近视防控的重点和难点。对于快速进展的早发型病理性近视和近视性牵拉性黄斑病变, 黄斑外加压手术是可行的治疗手法。其可根据手术后是否存在手术顶压嵴分为后巩膜加固手术与黄斑扣带手术, 两者在手术材料、手术方法和适应证上均有不同。在近视患病率飙升的大背景下, 需要不断完善、谨慎推广黄斑外加压手术, 为病理性近视的防控提供高质量的循证医学证据。

Pathological myopia,characterized by progressive elongation of the axial length and formation of posterior staphyloma,is accompanied by chorioretinal irreversible degeneration.It is also the focus and biggest challenge of myopia control and blindness prevention.For managing progressive early-onset pathologic myopia and myopic traction maculopathy,episcleral pressurization of macula is a practical option.It can be divided into posterior scleral reinforcement surgery and macular buckling surgery according to the presence or absence of operative top pressure ridge after surgery,both of which are different in terms of implanted materials,procedures and indications.The implanted materials,procedures and indications are different between the two.Under the background of soaring prevalence of myopia,it is necessary to modify and cautiously popularize the techniques of episcleral pressurization of macula to provide high level clinical evidence for management of pathological myopia.