目的：探讨23G玻璃体手术治疗视网膜静脉阻塞黄斑水肿合并玻璃体黄斑牵拉或视网膜黄斑前膜的临床疗效。

方法：对22例22眼视网膜静脉阻塞黄斑水肿合并玻璃体黄斑牵拉或黄斑前膜病例进行回顾性分析。其中12例12眼行23G玻璃体切除手术并剥离视网膜前膜和/或内界膜作为观察组即手术组； 另外10例10眼未行手术患者作为对照组，并收集全部患者治疗前、治疗后1、3、6mo的最佳矫正视力(BCVA)及中央视网膜厚度(CRT)资料进行统计学分析。

结果：观察组和对照组治疗前BCVA和CRT差异无统计学意义(P=0.645、0.206)。观察组术后各随访时间点BCVA较术前均明显提高，差异有统计学意义(F=2.895，P=0.048)； CRT较术前明显降低，差异均有统计学意义(F=16.431，P<0.01)。对照组随访期内1、3、6mo BCVA及CRT较治疗前无明显改善，差异均无统计学意义。随访期3、6mo时，观察组BCVA较对照组提高，CRT较对照组时降低，差异均有统计学意义(P<0.05)； 而1mo时，观察组BCVA及CRT较对照组无明显改善。

结论：23G玻璃体切割手术可以有效地提高视网膜静脉阻塞黄斑水肿合并玻璃体黄斑牵拉或黄斑前膜患者视力并降低中央视网膜厚度。

AIM: To evaluate 23G vitrectomy for macular edema in eyes with retinal vein occlusion(RVO)combined with vitreoretinal traction(VMT)or epiretinal membrane(ERM).

METHODS: Totally 22 patients(22 eyes)diagnosed with macular edema of RVO combined with VMT or ERM were retrospectively analyzed. Twelve cases performed with 23G vitrectomy together with peeling of inner limiting membrane(ILM)and/or ERM were considered as the observation group or intervention group. Ten cases without vitrectomy were recruited as control group. The best corrected visual acuity(BCVA)and central retinal thickness(CRT)at baseline, 1, 3 and 6mo were recorded and compared.

RESULTS: At baseline, the difference of BCVA and CRT between observation group and control group was not statistically significant(P=0.645, 0.206). After vitrectomy, the BCVA and CRT of RVO patients in observation group were significantly improved compared with baseline at each follow-up(F=2.895, P=0.048; F=16.431, P<0.01). However, the BCVA and CRT in control group remained the same as baseline at every follow-up. Moreover, the BCVA and CRT in observation group were much better than that in control group at both 3 and 6mo after vitrectomy. However, the BCVA and CRT between two groups were not significantly different at 1mo postoperatively.

CONCLUSION: The 23G vitrectomy could markedly improve BCVA and reduce CRT in RVO patients with macular edema combined with VMT and/or ERM.

国家自然科学基金项目(No.81460163、81400427、 81300786); 陕西省青年科技新星项目(No.2016KJXX-12); 陕西省自然科学基金项目(No.2016JM8029、2012JM4023); 西安交通大学基本科研业务费专项科研项目(No.1191320094); 教育部博士学科点基金(No.20133601120012); 江西省科技厅项目(No.20142BAB215029、20132BAB205024、20142BDH80005); 江西省教育厅科技项目(No.GJJ14094、GJJ13175)