Donati G, Kapetanios A D, Pournaras C J
Department of Clinical Neurosciences, University Hospitals of Geneva, Switzerland.
Graefes Arch Clin Exp Ophthalmol. 1998 Oct;236(10):739-46. doi: 10.1007/s004170050152.
Surgery has been successful in removing epiretinal membranes (ERM) from the macula, allowing some improvement in vision in 80-90% of patients; however, complications are relatively frequent. We conducted a retrospective study to evaluate the rate of peri- and postoperative complications and their influence on functional outcome of eyes having been operated on for ERM.
Preoperative findings, intraoperative and postoperative complications as final results of 70 consecutive cases of idiopathic or secondary ERM operated on by the same retina surgeon were analyzed.
In all cases the ERMs were successfully removed from the fovea. The mean visual acuity (VA) increased from 0.34 +/- 0.2 to 0.54 +/- 0.31 (P < 0.05) postoperatively. Idiopathic and secondary ERM both showed significant improvement after surgery. Complications included intraoperative hemorrhage and retinal tears and postoperative progressive nuclear sclerosis, retinal tears causing detachments, macular edema and retinal pigmentary epitheliopathy. Final VA was not significantly different from the mean after complications, apart from when retinal detachments involved the macular area.
Performing surgery for ERM is worthwhile in eyes with major decreased VA and in eyes with metamorphopsia but only moderately reduced vision. Postoperative complications are frequent but can usually be managed successfully. Of them, only retinal detachment has a negative effect on the final functional outcome.
手术已成功从黄斑区移除视网膜前膜(ERM),80 - 90%的患者视力有所改善;然而,并发症相对常见。我们进行了一项回顾性研究,以评估ERM手术患者围手术期和术后并发症的发生率及其对手术眼功能结局的影响。
分析了由同一位视网膜外科医生连续进行手术的70例特发性或继发性ERM患者的术前检查结果、术中及术后并发症等最终结果。
所有病例中ERM均成功从黄斑中心凹移除。术后平均视力(VA)从0.34±0.2提高到0.54±0.31(P < 0.05)。特发性和继发性ERM术后均有显著改善。并发症包括术中出血和视网膜裂孔,以及术后进行性核硬化、导致视网膜脱离的视网膜裂孔、黄斑水肿和视网膜色素上皮病变。除视网膜脱离累及黄斑区外,最终视力与并发症后的平均视力无显著差异。
对于视力严重下降的眼以及有视物变形但视力仅中度下降的眼,进行ERM手术是值得的。术后并发症常见,但通常可成功处理。其中,只有视网膜脱离对最终功能结局有负面影响。