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目的 :探讨视网膜脱离 (简称网脱 )复位手术后黄斑皱褶的发生原因、手术治疗和预防措施。方法 :分析总结了 31例网脱复位术后发生黄斑皱褶的特点 ,并进行玻璃体手术治疗。应用视网膜钩、铲、眼内镊子、笛形针等器械将黄斑前膜剥离 ,使皱褶松开。结果 :黄斑皱褶产生的主要因素包括 :大的马蹄形裂孔、冷凝过度、术中眼内出血、术后裂孔后缘皱襞和不恰当的眼底激光治疗等。通过玻璃体手术 ,31例黄斑皱褶被完全松解并恢复正常黄斑形态 ,未见严重并发症产生。随访时视力均有明显提高。结论 :黄斑皱褶是现代网脱复位术常见并发症之一 ,再次玻璃体手术是有效的治疗方法。它可以通过网脱手术操作的改进而得以预防。
Objective: To investigate the causes, surgical treatment and preventive measures of macular folds after retinal detachment surgery. Methods: The characteristics of macular folds in 31 cases treated with reattachment were summarized and vitrectomy was performed. Apply retinal hooks, shovels, intraocular tweezers, flute needles and other devices to peel the anterior membrane of the macula to release the folds. Results: The main causes of macular folds include: large horseshoe-shaped holes, excessive condensation, intraocular hemorrhage, posterior foramen folds and improper fundus laser treatment. Through vitreous surgery, 31 cases of macular folds were completely released and returned to normal macular morphology, no serious complications were found. Visual acuity was significantly improved at follow-up. Conclusion: Macular folds are one of the common complications of modern off-grid surgery. Once again vitrectomy is an effective treatment. It can be prevented by the improvement of net surgery.