摘要
玻璃体切割手术联合内界膜（ILM）剥除及玻璃体填充物眼内填充是治疗黄斑裂孔（MH）的常规方法，但手术后视力和MH闭合率等手术效果仍有待进一步提高。切除玻璃体后皮质后，逆时针环形剥除约1个视盘直径大小的ILM，其末端留一小蒂并将其反折填塞到MH中，然后剥除MH周围至上下血管弓范围内的ILM。ILM翻瓣手术是MH玻璃体切割手术的重要改进方法之一，对于直径较大、ILM剥除手术后MH仍未闭合等复杂特殊的MH具有较好的治疗效果；较常规玻璃体切割手术联合ILM剥除更能提高MH闭合率，改善患者视力。但目前针对ILM翻瓣手术缺乏大样本临床试验观察，仍需要更多病例以及更长时间的随访才能对这一技术的有效性和安全性进行更为充分准确地评价。
Vitrectomy combined with internal limiting membrane （ILM） peeling and vitreous tamponade is a conventional method for treating macular hole （MH）, but the visual acuity and MH closure rate remains to be further improved. After removal of posterior vitreous cortex, the ILM is grasped with an ILM forceps and peeled off in a circular fashion for approximately 1 disc diameters around the MH. During the circumferential peeling, the ILM is not removed completely from the retina hut is left attached to the edges of the MH. The ILM was then massaged gently over the MH from all sides until the ILM became inverted and then peel all other ILM within vascular arcades. Inverted ILM flap technique is one of the important improvement methods in MH vitrectomy, especially for MH with large diameter and unhealed MH after ILM peeling. Compared with conventional vitrectomy combined with ILM peeling, inverted ILM flap technique can enhance MH closure and improve visual acuity. Due to lack of large sample observation in clinical trials of inverted ILM flap technique, we still need more cases and longer follow-up of this technology to more accurately evaluate the effectiveness and safety of this technique.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2016年第5期561-563,共3页
Chinese Journal of Ocular Fundus Diseases
