目的:探讨硅油填充眼继发性黄斑前膜的短期手术疗效,评价视网膜内界膜剥除术对疗效的影响。方法:病例对照研究。回顾性分析玻璃体视网膜手术的硅油填充眼继发性黄斑前膜病例65例65眼的临床病例资料,其中单纯剥膜组34例34眼,联合内界膜剥除组31例31眼,随访>3mo。比较各组治疗前和术后3mo的最佳矫正视力,黄斑中央厚度,多焦视网膜电图振幅密度,并作组间比较。结果:单纯剥膜组最佳矫正视力术前4.1±0.3,术后4.5±0.5,黄斑中央厚度术前424±54μm,术后355±43μm,多焦视网膜电图第一环P1振幅密度术前23±7.3nV/deg2,术后26±8.5nV/deg2。联合内界膜剥除组最佳矫正视力术前4.2±0.1,术后4.5±0.4,黄斑中央厚度术前436±68μm,术后348±53μm,多焦视网膜电图第一环P1振幅密度术前24±7.8nV/deg2,术后27±9.7nV/deg2。各组治疗前后差异有统计学意义(P<0.05),组间比较差异均无统计学意义。结论:前膜剥除术治疗硅油填充眼继发性黄斑前膜疗效确切,联合视网膜内界膜剥除对短期预后影响不明显。

AIM:To explore the short-term surgery results for secondary epimacular membrane in silicone oil tamponade eyes,and to evaluate the effect influence after internal limiting peeling surgery.·METHODS:It was a case control study. 65 patients 65 eyes with secondary epimacular membrane in silicone oil tamponade who underwent silicone oil removal and epimacular membrane peeling(EMP) combined with or without internal limiting membrane peeling(ILMP) were retrospectively analyzed.They were divided into single EMP group 34 eyes and combined with ILMP group(CILMP) (31 eyes).The follow-up time was more than 3 months. Best corrected visual acuity(BCVA),optical coherence tomography (OCT) and multifocal electroretinogram(mfERG) were exeamined preoperatively and 3 months postoperatively respectively. The change of BCVA,foveal thickness(FT),amplitude density of wave P1 of ring 1 by mfERG were analyzed before and after surgery and the results were also analyzed statistically in both groups.·RESULTS:BCVA,FT and amplitude density of P1 were 4.1±0.3,424±54μm,and 23±7.3nV/deg2 respectively before surgery and they were 4.5±0.5,355±43μm,and 26±8.5nV/deg2 respectively after surgery in EMP group. BCVA,FT and amplitude density of P1 were 4.2±0.1,436±68μm and 24±7.8nV/deg2 before surgery and 4.5±0.4,348±53μm and 27±9.7nV/deg2 after sugery in CILMP group.There was significant difference between preoperation and postoperation in every group regarding BCVA,FT,amplitude of wave P1 of ring 1 by mfERG(P<0.05). But there was no significant difference between the two groups before or after suegery.·CONCLUSION:EMP is an efficient surgery for the treatment of secondary epimacular membrane in silicone oil tamponaded eyes. Combined with ILMP may not benefit econdary epimacular membrane in silicone oil tamponade eyes in short-term after surgery.

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