目的：评价3D手术视频系统及术中光学相干断层扫描(OCT)在特发性黄斑前膜玻璃体切除术中的应用效果。

方法：回顾性临床研究。选取2023-01/10在新疆四七四医院眼科治疗的特发性黄斑前膜患者61例61眼，按手术方式分为两组：3D组31例31眼采用3D手术视频系统及术中OCT技术，传统手术组30例30眼采用Resight非接触广角镜系统手术。记录两组患者手术时间及剥膜时间，随访6 mo，分析两组术后最佳矫正视力(BCVA)、眼压(IOP)、黄斑区视网膜厚度(CMT)、并发症。

结果：所有患者均顺利完善手术，术中均未发生视网膜大出血、视网膜裂孔、视网膜脱离等严重并发症，术后均未出现眼内炎、继发性青光眼等并发症。3D组手术时间和剥膜时间明显短于传统手术组(20.13±1.59 vs 25.97±2.09 min； 3.74±0.89 vs 8.13±1.72 min，均P<0.001)。两组患者术后1 mo BCVA、CMT与术前比较均无差异(均P>0.008)，术后3、6 mo BCVA、CMT均较术前改善(均P<0.008)。术后6 mo，3D组BCVA较传统手术组明显改善(P=0.007)。术后各时间点两组间CMT和眼压比较均无差异(均P>0.05)。

结论：3D手术视频系统及传统手术组均可治疗特发性黄斑前膜，但3D手术视频系统术中OCT在缩短手术时间，提高手术效率，改善精细手术步骤方面更有优势。

METHODS: A retrospective analysis was conducted on 61 patients(61 eyes)with idiopathic epiretinal membrane at our hospital from January 2023 to October 2023. The patients were divided into two groups based on the surgical methods: with 31 patients(31 eyes)who underwent surgery using the 3D surgical video system and intraoperative OCT technology in 3D group, and 30 patients(30 eyes)underwent surgery using the Resight non-contact wide-angle lens system in traditional surgery group. Surgical time, membrane peeling time were recorded, followed-up for 6 mo, post-operative best-corrected visual acuity(BCVA), intraocular pressure(IOP), central macular thickness(CMT), and complications were analyzed for the two groups.

RESULTS:All patients successfully underwent surgery without experiencing serious intraoperative complications such as major retinal hemorrhage, retinal tears, or retinal detachment. Additionally, no postoperative complications such as endophthalmitis or secondary glaucoma occurred. The surgical duration and membrane peeling time in the 3D group were significantly shorter than those in the traditional surgery group(20.13±1.59 vs 25.97±2.09 min; 3.74±0.89 vs 8.13±1.72 min, respectively; both P<0.001). There were no significant differences in BCVA and CMT between preoperative and 1-month postoperative values for both groups of patients(both P>0.008). However, both BCVA and CMT improved significantly at 3 and 6 mo postoperatively compared to preoperative levels(both P<0.008). At 6 mo postoperatively, the BCVA in the 3D group was significantly better than that in the traditional surgery group(P=0.007). There were no significant differences in CMT or IOP between the two groups at any postoperative time point(all P>0.05).

CONCLUSION: Both the 3D surgical video system and the traditional surgical group can treat idiopathic epiretinal membrane, but the 3D surgical video system has advantages in shortening the surgical time, improving surgical efficiency, and enhancing the precision of surgical steps during surgery with the assistance of intraoperative OCT.