Kadonosono K, Yazama F, Itoh N, Uchio E, Nakamura S, Akura J, Sawada H, Ohno S
Department of Ophthalmology, Yokohama City University School of Medicine, 4-57 Urafune-cho Minami-ku, Yokohama 232-0024, Japan.
Am J Ophthalmol. 2001 Feb;131(2):203-7. doi: 10.1016/s0002-9394(00)00728-5.
To examine the efficacy of vitrectomy with internal limiting membrane removal for retinal detachment resulting from a macular hole in highly myopic eyes.
Eleven consecutive highly myopic eyes (11 patients) with retinal detachment resulting from a macular hole were treated by vitrectomy with removal of the internal limiting membrane, which was stained with indocyanine green and sulfur hexafluoride gas injection. Postoperatively, the patients were instructed to remain prone for 2 weeks. The excised specimens were evaluated with transmission electron microscopy.
The mean postoperative follow-up was 9.2 +/- 2.3 months (range, 7 to 13 months). In 10 of the 11 eyes (91%) the retina was reattached during the initial surgery. Redetachment occurred in one eye, which was successfully treated during the second surgery. Best-corrected visual acuity improved in all eyes and ranged from 20/400 to 20/50. Pathologic examination showed that the internal limiting membrane and epiretinal tissues were present in all specimens.
The use of indocyanine green staining can facilitate removal of a macular internal limiting membrane and overlying epiretinal membrane, resulting in complete relief of the macular traction. Primary removal of the internal limiting membrane may contribute to a high initial success rate for retinal reattachment and be an important adjuvant to the treatment of retinal detachment resulting from a macular hole in highly myopic eyes.
探讨玻璃体切除术联合内界膜剥除术治疗高度近视眼黄斑裂孔性视网膜脱离的疗效。
连续选取11例（11只眼）高度近视眼黄斑裂孔性视网膜脱离患者，行玻璃体切除术联合内界膜剥除术，术中用吲哚菁绿染色内界膜并注入六氟化硫气体。术后嘱患者俯卧位2周。切除的标本行透射电子显微镜检查。
术后平均随访9.2±2.3个月（范围7至13个月）。11只眼中10只眼（91%）在初次手术时视网膜复位。1只眼发生再脱离，在二次手术时成功治疗。所有患眼最佳矫正视力均有提高，范围从20/400至20/50。病理检查显示所有标本中均存在内界膜和视网膜前组织。
使用吲哚菁绿染色有助于剥除黄斑内界膜及上方的视网膜前膜，从而完全解除黄斑牵拉。初次剥除内界膜可能有助于提高视网膜复位的初始成功率，是治疗高度近视眼黄斑裂孔性视网膜脱离的重要辅助手段。
