Gelman Rachel, Stevenson William, Prospero Ponce Claudia, Agarwal Daniel, Christoforidis John Byron
Department of Ophthalmology, University of Arizona Medical Center, Tucson, AZ 85711, USA.
J Ophthalmol. 2015;2015:939748. doi: 10.1155/2015/939748. Epub 2015 Sep 3.
The internal limiting membrane (ILM), the basement membrane of the Müller cells, serves as the interface between the vitreous body and the retinal nerve fiber layer. It has a fundamental role in the development, structure, and function of the retina, although it also is a pathologic component in the various vitreoretinal disorders, most notably in macular holes. It was not until understanding of the evolution of idiopathic macular holes and the advent of idiopathic macular hole surgery that the idea of adjuvant ILM peeling in the treatment of tractional maculopathies was explored. Today intentional ILM peeling is a commonly applied surgical technique among vitreoretinal surgeons as it has been found to increase the rate of successful macular hole closure and improve surgical outcomes in other vitreoretinal diseases. Though ILM peeling has refined surgery for tractional maculopathies, like all surgical procedures it is not immune to perioperative risk. The essential role of the ILM to the integrity of the retina and risk of trauma to retinal tissue spurs suspicion with regard to its routine removal. Several authors have investigated the retinal damage induced by ILM peeling and these complications have been manifested across many different diagnostic studies.
内界膜（ILM）是 Müller 细胞的基底膜，作为玻璃体与视网膜神经纤维层之间的界面。它在视网膜的发育、结构和功能中起着重要作用，尽管它也是各种玻璃体视网膜疾病中的病理成分，最显著的是在黄斑裂孔中。直到对特发性黄斑裂孔的演变有了认识以及特发性黄斑裂孔手术出现后，才开始探索辅助性内界膜剥除术治疗牵引性黄斑病变的想法。如今，故意进行内界膜剥除术是玻璃体视网膜外科医生常用的手术技术，因为已发现它能提高黄斑裂孔成功闭合的几率，并改善其他玻璃体视网膜疾病的手术效果。尽管内界膜剥除术改进了牵引性黄斑病变的手术，但与所有手术一样，它也无法避免围手术期风险。内界膜对视网膜完整性的重要作用以及对视网膜组织造成创伤的风险引发了对其常规切除的怀疑。几位作者研究了内界膜剥除术引起的视网膜损伤，这些并发症在许多不同的诊断研究中都有体现。
