Janknecht P
Augenzentrum Wangen, Wangen im Allgäu.
Klin Monbl Augenheilkd. 2010 Feb;227(2):135-7. doi: 10.1055/s-0028-1109734. Epub 2010 Feb 12.
The prevalence of a posterior vitreous detachment in patients with an idiopathic epiretinal membrane is often exaggerated in the literature. This may make the surgeon become overconfident during vitrectomy.
34 patients with an idiopathic epiretinal membrane (mean age 72.9 years) were vitrectomised. The membrane and with it the remaining vitreous were stained with Membrane Blue.
The preoperative visual acuity was -0.6 +/- 0.176 logMar units. Visual acuity increased postoperatively to -0.3 +/- 0.252 logMar units after 372.6 days. A posterior vitreous detachment was found in 17 patients (50 %), whereas there was none in the remaining 50 %. There was no correlation between age and prevalence of vitreous detachment.
The increase in visual acuity was very encouraging. In contrast to reports in the older literature one cannot expect to find a posterior vitreous detachment in patients with an idiopathic epiretinal membrane. This can be checked intraoperatively very easily with Membrane Blue. Such a check becomes more urgent as the posterior vitreous detachment cannot be achieved with 23-G vitrectomy as easily as with 20-G vitrectomy.
特发性视网膜前膜患者中后玻璃体脱离的发生率在文献中常常被夸大。这可能会使外科医生在玻璃体切除术中过度自信。
对34例特发性视网膜前膜患者（平均年龄72.9岁）进行了玻璃体切除术。用膜蓝对视网膜前膜及其剩余玻璃体进行染色。
术前视力为-0.6±0.176 logMar单位。术后372.6天后，视力提高到-0.3±0.252 logMar单位。17例患者（50%）发现有后玻璃体脱离，其余50%未发现。玻璃体脱离的发生率与年龄之间无相关性。
视力提高非常令人鼓舞。与早期文献报道不同，特发性视网膜前膜患者不一定会出现后玻璃体脱离。术中使用膜蓝可以很容易地对此进行检查。由于23G玻璃体切除术不像20G玻璃体切除术那样容易实现后玻璃体脱离，这种检查变得更加迫切。
