Russell S R, Hageman G S
Department of Ophthalmology and Visual Sciences, University of Iowa, 200 Hawkins Dr, Room 11196 I, Iowa City, IA 52242, USA.
Arch Ophthalmol. 2001 Nov;119(11):1653-8. doi: 10.1001/archopht.119.11.1653.
To evaluate the morphologic outcomes resulting from surgical vitreoretinal separation in young adult primates.
Vitrectomy and mechanical separation of the vitreous from the internal limiting lamina (ILL) of the posterior retina and surface of the optic disc were performed on 25 young adult cynomolgus monkey eyes in vivo. Lectin histochemical studies were used to evaluate the vitreoretinal interface. Morphologic outcomes were tabulated.
In 11 of 25 eye regions, residual vitreous remained attached to the ILL in some of the regions. Localized ILL breaks or separation of the ILL from the neural retina was noted in 9 eyes. Retinal tissue loss, including avulsion of the ganglion cell, inner plexiform, or inner nuclear layers, was observed in 7 eyes. Avulsion of axon bundles in the optic disc was noted in 9 eyes. Significantly, partial- or full-thickness foveal tears were noted in 11 eyes. Based on the surgeons' intraoperative observations, small superficial optic disc or retinal hemorrhages were observed in 3 of 25 eyes. None of the eyes on which a vitrectomy alone was performed showed ILL damage, or retinal or optic disc tissue loss.
Damage may occur to the optic disc, fovea, and extrafoveal retina as a result of surgical separation of the vitreous from the retina in young adult primates.
These data support the contention that surgically induced damage at the level of the vitreoretinal interface may help explain the visual field defects noted after surgery to close full-thickness macular holes. These data also support the need for developing additional modalities to assist in vitreous separation, thereby reducing the risk of traumatic complications associated with purely mechanical procedures.
评估成年灵长类动物手术性玻璃体视网膜分离后的形态学结果。
对25只成年食蟹猴眼进行活体玻璃体切除术，并将玻璃体从视网膜后部的内界膜（ILL）及视盘表面进行机械分离。采用凝集素组织化学研究评估玻璃体视网膜界面。将形态学结果制成表格。
在25个眼区中的11个，部分区域仍有残留玻璃体附着于ILL。9只眼中观察到ILL局部断裂或ILL与神经视网膜分离。7只眼中观察到视网膜组织丢失，包括神经节细胞层、内丛状层或内核层的撕脱。9只眼中观察到视盘轴突束撕脱。值得注意的是，11只眼中观察到部分或全层黄斑裂孔。根据手术医生的术中观察，25只眼中有3只出现小的浅表视盘或视网膜出血。仅行玻璃体切除术的眼中均未出现ILL损伤、视网膜或视盘组织丢失。
成年灵长类动物手术性玻璃体与视网膜分离可能对视盘、黄斑和黄斑外视网膜造成损伤。
这些数据支持这样的观点，即手术引起的玻璃体视网膜界面损伤可能有助于解释全层黄斑裂孔关闭手术后出现的视野缺损。这些数据还支持开发其他辅助玻璃体分离的方法的必要性，从而降低与单纯机械手术相关的创伤性并发症的风险。
