人羊膜在难治性黄斑裂孔治疗中的应用

Progress in the treatment of refractory macular hole by human amniotic membrane

难治性黄斑裂孔的手术治疗是临床棘手问题,预后具有不确定性。目前难治性黄斑裂孔尚无统一定义,通常将病程长、孔径大、初次手术失败等的黄斑裂孔统称为难治性黄斑裂孔。扩大内界膜剥除范围或采用自体组织填塞可使部分难治性黄斑裂孔闭合。人羊膜是一种具有较强抗炎、抗纤维化等作用的膜状组织,以往广泛用于治疗眼表疾病,近年也尝试应用于治疗难治性黄斑裂孔,在改善黄斑区视网膜结构及视功能等方面取得一定效果。本文汇集国内外研究文献,重点总结人羊膜在难治性黄斑裂孔治疗中的作用机制、疗效以及应用前景,以期为临床开展相关工作和研究提供参考。

The surgery of refractory macular hole is often very tough for its uncertain prognosis.There is no unified definition for refractory macular hole,which usually refers to macular hole with a long duration,large diameter,or failure of initial operation.Treatment success can be achieved in some cases by expanding the range of internal limiting membrane peeling or filling with autologous tissue.Human amniotic membrane is a kind of tissue with strong anti-inflammatory and anti-fibrosis effects,and has been widely used in the treatment of ocular surface diseases.In recent years,amniotic membrane has been used in treating refractory macular hole.Some positive results have been achieved,including improvement of postoperative macular structure and increase of visual function.This review focuses on the mechanism,efficacy and prospect of human amniotic membrane in the treatment of refractory macular hole,providing reference for clinical practice and research.