目的：比较玻璃体切除术+黄斑前膜剥除术联合或不联合空气填充治疗特发性黄斑前膜的效果。

方法：特发性黄斑前膜42例46眼均合并有老年性白内障，A组23例25眼，行玻璃体切除并黄斑前膜剥除术联合空气填充； B组19例21眼，行玻璃体切除术+黄斑前膜剥除术。比较两组患者手术前后和组间视力、黄斑中心区厚度(central macular thickness，CMT)。观察两组患者术中和术后并发症发生情况。

结果：术前，两组患者年龄、术前视力、黄斑厚度比较，差异均无统计学意义(P>0.05)。术后1wk，3、6mo，两组患者视力均显著改善，CMT均明显减小，与术前比较差异均有统计学意义(P<0.05)。术后两组患者间视力、CMT比较，差异均无统计学意义(P>0.05)，且术后两组患者视力与黄斑厚度均无相关性。两组患者术中和术后均无严重并发症发生。

结论：玻璃体切除术+黄斑前膜剥除术联合或不联合空气填充术均能安全、有效地治疗特发性黄斑前膜，同时联合空气填充术未显示优势。

METHODS: Forty-two cases of IMEM patients(46 eyes)associated with cataract were randomly divided into two groups. Twenty-five eyes of 23 cases in Group A were performed with vitrectomy with macular epiretinal membrane peeling combined with air tamponade. The other 21 eyes of 19 cases in Group B only underwent vitrectomy and macular epiretinal membrane peeling(without air tamponade). The visual acuity and central macular thickness(CMT)were compared between the two groups before and after the surgery. The intraoperative and postoperative complications were also observed in both groups in the mean time.

RESULTS: There was no statistical significant difference between two groups in age, visual acuity and CMT before operation(P>0.05). By 1wk, 3 and 6mo follow-up after operation, mean visual acuity improved significantly; mean CMT decreased obviously in both groups after the operation and the difference was statistically significant(P<0.05). But for mean visual acuity and CMT, there were not statistically significant difference between two groups postoperatively at the same time(P>0.05),there was no correlation between postoperative mean visual acuity and CMT in the two groups. No serious complications occurred during and after operation.

CONCLUSION: Vitrectomy with macular epiretinal membrane peeling can be a safe and effective treatment for IMEM, meanwhile air tamponade in vitreous cavity does not reveal more advantages in the treatment.