目的：总结10个源自中国典故传统策略在治疗增殖性糖尿病视网膜病变的手术要领，在真实世界中分析这些要领的应用情况。

方法：回顾性、非对比性、干预性的研究。从10个源自古代中国哲学的传统策略(釜底抽薪、知己知彼、擒贼擒王、围城打援、融会贯通、分而治之、见缝插针、隔山打牛、左右开弓、四两拨千斤)总结并提炼手术要领。选取于2016-01/2024-02在我院行经睫状体平坦部玻璃体切除术346例443眼。根据每例患者的具体情况，在手术中灵活组合并使用这些技术要领。根据是否存在牵拉性视网膜脱离，分析这些技术要领的应用频率、有效性和安全性。

结果：纳入的所有患者共进行了473次手术。结合中国典故传统策略，提炼出10个手术要领。应用这些要领的不同组合，所有玻璃体切除术都进展顺利，除10例11眼外，其余患者均成功剥除增殖膜。而这11眼，应用了第十项技术策略(最小量膜切除法)，即只做必要的松解切口，故意保留大部分增殖膜。最终视力较术前改善或稳定(LogMAR视力：术前1.92±0.83 vs 术后1.16±0.85，P<0.01)。术后主要并发症包括早期的前房炎症反应和晶状体的核硬化。玻璃体切除术后复发性玻璃体出血、视网膜脱离和前房积血或新生血管性青光眼的发生几率分别为1.9%(9/473)、3.2%(15/473)、0.4%(2/473)和0.4%(2/473)。其中黄斑区视网膜脱离占1.9%(9/473)，再行多次玻璃体切除术。最终，98.9%患眼实现了黄斑区视网膜复位。未复位的5眼均存在严重的增殖膜和继发性硅油下视网膜脱离，其中3眼进行了巩膜外加压术。

结论：这10个传统策略提炼的技术要领在处理严重增殖性糖尿病视网膜病变时，绝大部分有效且安全。深入理解了每个典故传统策略的含义，记忆和应用这些要领会相对容易。可根据患者的具体情况来灵活应用不同的组合。

METHODS: Retrospective, noncomparative, interventional study. Ten surgical pearls were summarized and adapted from the ancient Chinese philosophy. Totally 346 cases(443 eyes)that underwent pars plana vitrectomy(PPV)at our hospial from January 2016 to February 2024 were selected. Flexible combinations of these pearls were applied according to the specific condition of each patient during surgeries. The efficacy and safety were analyzed, as well as the application frequencies according to the existence of tractional retinal detachment or not.

RESULTS: A total of 473 times of surgeries were performed on all the patients. According to ancient Chinese allusions, ten surgical pearls were summarized from these surgeries. All PPVs went smoothly with the application of different combinations. Finally, almost all proliferative membranes were successfully peeled except for 10 patients(11 eyes), who went through strategy No.10(minimal membranectomy)that, only necessary relaxation incisions were made with most of the proliferative membranes left on purpose. The final visual acuities were mostly improved or stable(1.92±0.83 LogMAR preoperatively vs 1.16±0.85 LogMAR postoperatively, P<0.01). Postoperative complications mainly included early inflammatory responses in the anterior chamber and nuclear sclerosis. Recurrent vitreous hemorrhage, retinal detachment, and hyphema or neovascular glaucoma occurred in 1.9%(9/473), 3.2%(15/473), 0.4%(2/473)and 0.4%(2/473)times of PPVs, respectively. After 12/473(2.5%)times of PPVs, retinal detachment at the macular area still existed, and multiple times of subsequent PPVs were conducted. Final retinal attachment at the macular area was realized in 98.9% eyes. Those 5 unattached eyes were with heavily reproliferated membranes and subsequent tractional retinal detachment recurrence under the oil, and three of them were scleral buckled additionally.

CONCLUSION:These 10 surgical strategies and technique pearls were mostly effective and safe in the management of severe PDR patients. They were relatively easy to be memorized and applicated once the meaning of each Chinese idiom was understood. One can use different combinations flexibly according to a patient's specific condition.