Iuliano Lorenzo, Fogliato Giovanni, Gorgoni Francesca, Corbelli Eleonora, Bandello Francesco, Codenotti Marco
Ospedale San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Ospedali Riuniti di Ancona, Università Politecnica Delle Marche, Ancona, Italy.
Clin Ophthalmol. 2019 Jul 15;13:1253-1265. doi: 10.2147/OPTH.S176120. eCollection 2019.
This review aims to give to the reader an overview selectively oriented on safety and efficacy of surgery, providing concise and direct answers about crucial questions of trainees and experts. Surgery for idiopathic epiretinal membrane (ERM) is a safe and effective procedure that can achieve long-term stable postoperative visual and anatomical improvement, with an overall low recurrence and complication rate. Young patients, with a short onset of symptoms and with better initial visual acuity achieve higher levels of visual outcome. The preoperative degree of metamorphopsia is the prognostic factor for their postoperative degree. Successful results may be obtained in eyes with specific optical coherence tomography criteria, such as thin ganglion cell layers, thin internal plexiform layer, longer photoreceptors outer segment, regular ellipsoid zone and cone outer segment tips line, and without ectopic inner foveal layer. Internal limiting membrane peeling demonstrates positive anatomical and functional outcomes, but final positions about its safety remain controversial.
本综述旨在有针对性地为读者提供关于手术安全性和有效性的概述，就实习医生和专家的关键问题提供简洁直接的答案。特发性视网膜前膜（ERM）手术是一种安全有效的手术，可实现术后长期稳定的视力和解剖学改善，总体复发率和并发症发生率较低。症状出现时间短且初始视力较好的年轻患者视力改善水平更高。术前变形视的程度是其术后程度的预后因素。在具有特定光学相干断层扫描标准的眼中可获得成功结果，如神经节细胞层薄、内网状层薄、光感受器外段长、椭圆体带规则以及锥体外段尖端线，且无中心凹内异位层。内界膜剥除显示出积极的解剖学和功能结果，但其安全性的最终定论仍存在争议。
