【摘要】 目的探讨手术治疗特发性黄斑视网膜前膜(IMEM)后内界膜(ILM)的存在和完整性分析。方法分析2016年2月至2018年2月于我院因IMEM行手术治疗的83例(83只眼)患者,所有的患者随机分配到观察组(n=42)或对照组(n=41),所有的患者均予以玻璃体切除联合台盼蓝染色下黄斑视网膜前膜(MEM)剥除术,而观察组患者额外予以亮蓝G染色下ILM剥除术。术后所有的标本均行组织病理学检验。结果术后末次随访时两组患者的最佳矫正视力(BCVA)及黄斑中心凹视网膜厚度(FMT)相比较并无显著统计学差异(P> 0. 05),但观察组的IMEM的复发率明显低于对照组(χ2=4. 623,P=0. 032)。术中经染色剂染色证实76例标本存在ILM的完整性受损,术中应用台盼蓝染色证实MEM存在的敏感度为95. 1%,而术中应用亮蓝G证实ILM存在的敏感度为97. 5%。结论手术过程中单纯剥除MEM而保留ILM的完整性是相对困难的,但剥除ILM后IMEM的复发率明显降低,而应用染色剂证实ILM的存在和完整性与组织病理学结果存在良好的一致性。更多还原

【Abstract】 Objective To investigate the existence and integrity of the internal limiting membrane( ILM) after surgical treatment of idiopathic macular epiretinal membrane( IMEM). Methods Eighty-three patients( 83 eyes) who underwent surgery for the IMEM in our hospital from February 2016 to February 2018 were enrolled. All patients were randomly assigned to the observation group( n = 42) or the control group( n = 41). All patients underwent vitrectomy combined with trypan blue assisted macular epiretinal membrane( MEM) peeling,while patients in the observation group were additionally treated with brilliant blue G assisted ILM peeling. All specimens were examined by histopathology post-surgically. Results There was no significant difference in best-corrected visual acuity or FMT between the two groups at the last follow-up( p > 0. 05),but the recurrence rate of IMEM in the observation group was significantly lower than that in the control group( χ~2= 4. 623,P = 0. 032). Intraoperative staining confirmed that the integrity of ILM was impaired in 76 specimens. The sensitivity of intraoperative trypan blue staining for MEM existence was 95. 1%,and the sensitivity of brilliant blue G was 97. 5%. Conclusions It is relatively difficult to solely remove MEM and preserve the integrity of ILM during surgery. However,the recurrence rate of IMEM is significantly reduced after ILM peeling. The use of stains shows good agreement with histopathological findings for the demonstration of the existence and integrity of ILM.更多还原