Torii H, Takahashi K, Yoshitomi F, Miyata K, Ishii Y, Oshika T
Ukinojo Eye Center, Miyazaki, Japan. Yoshitomi Eye Center, Fukuoka, Japan.
Ophthalmology. 2001 Dec;108(12):2182-5. doi: 10.1016/s0161-6420(01)00819-3.
To investigate the incidence of spontaneous detachment of the anterior hyaloid membrane from the posterior lens capsule and to explore the possibility of surgical separation of the anterior hyaloid membrane.
Prospective nonrandomized interventional comparative trial and comparative human tissue study.
Thirty-eight eyes of 32 patients undergoing primary pars plana vitrectomy combined with cataract extraction and intraocular lens implantation and 3 eye bank eyes for histopathologic examination.
The anterior hyaloid membrane and posterior lens capsule were observed with a fiberoptic endoscope. Surgical separation of the anterior hyaloid membrane was attempted by either the hydrodissection method before cataract extraction (18 eyes) or the direct suction method after cataract extraction (20 eyes). In eye bank eyes, histopathologic examination was performed with (one eye) and without (two eyes) surgical separation of the anterior hyaloid membrane.
Incidence of spontaneous detachment and success rate of surgical detachment of the anterior hyaloid membrane.
No eye displayed spontaneous detachment of the anterior hyaloid membrane. Using the hydrodissection method, complete detachment of the anterior hyaloid membrane was achieved in 10 eyes (55.6%), partial detachment was attained in 2 eyes (11.1%), and detachment was not induced at all in 6 eyes (33.3%). With the direct suction method, the anterior hyaloid membrane was completely separated from the posterior lens capsule in 10 eyes (50%), partially detached in 10 eyes (50%), and not detached at all in any eye. The direct suction method had a significantly higher success rate than the hydrodissection method (P < 0.001, chi-square test). In eye bank eyes, the surgical manipulation induced complete separation of the anterior hyaloid membrane from the lens capsule.
Spontaneous detachment of the anterior hyaloid membrane from the posterior lens capsule is very rare. Under endoscopic observation, surgical detachment of the anterior hyaloid membrane was possible in half of the patients.
探讨晶状体后囊前玻璃体膜自发脱离的发生率，并探索手术分离前玻璃体膜的可能性。
前瞻性非随机干预性对照试验及人体组织对照研究。
32例行一期扁平部玻璃体切除术联合白内障摘除及人工晶状体植入术患者的38只眼，以及3只用于组织病理学检查的眼库眼。
用纤维内镜观察前玻璃体膜及晶状体后囊。在白内障摘除术前采用水分离法（18只眼）或白内障摘除术后采用直接抽吸法（20只眼）尝试手术分离前玻璃体膜。对眼库眼，分别在进行（1只眼）和未进行（2只眼）前玻璃体膜手术分离的情况下进行组织病理学检查。
前玻璃体膜自发脱离的发生率及手术分离的成功率。
未发现前玻璃体膜自发脱离的病例。采用水分离法时，10只眼（55.6%）实现了前玻璃体膜的完全脱离，2只眼（11.1%）部分脱离，6只眼（33.3%）未诱导出脱离。采用直接抽吸法时，10只眼（50%）的前玻璃体膜与晶状体后囊完全分离，10只眼（50%）部分脱离，无1只眼未脱离。直接抽吸法的成功率显著高于水分离法（P<0.001，卡方检验）。在眼库眼中，手术操作导致前玻璃体膜与晶状体囊完全分离。
晶状体后囊前玻璃体膜自发脱离非常罕见。在内镜观察下，半数患者可实现前玻璃体膜的手术分离。
