目的：探讨玻璃体切除术(PPV)联合保留中心凹的内界膜(ILM)剥除及硅油(SO)填充治疗病理性近视黄斑劈裂(PMF)的临床疗效。

方法：本文为回顾性观察性研究，收集2023年1月至2024年11月在我院接受玻璃体切除术联合保留中心凹的内界膜剥除及硅油填充治疗病理性近视黄斑劈裂10例10眼。比较术前，术后1 wk，1、3 mo最佳矫正视力(BCVA)、中心凹厚度(CFT)、视网膜劈裂腔高度(FS)及黄斑劈裂、中心凹脱离复位情况。

结果： 纳入病理性近视黄斑劈裂10例10眼中，完全复位率为30%(3眼)，部分复位率为70%(7眼)。术后3 mo， BCVA(LogMAR)较术前1.432±0.509显著改善至0.957±0.393(P<0.05)，CFT和FS较术前437.9±180.4、686.5±172.2 μm显著降低至207.5±76.1、290.7±86.6 μm(P<0.05)。术中及术后随访期间未见黄斑裂孔、视网膜脱离、硅油乳化、眼内炎等并发症发生。

结论：玻璃体切除术联合保留中心凹的内界膜剥除及硅油填充有助于病理性近视黄斑劈裂患者的视力提高及黄斑劈裂的解剖复位。

METHODS:This study is a retrospective observational analysis of 10 cases(10 eyes)diagnosed with PMF that underwent PPV with fovea-sparing ILM peeling and SO tamponade between January 2023 and November 2024. The best-corrected visual acuity(BCVA), central foveal thickness(CFT), foveoschisis(FS), and the detachment and reattachment of FS and macular fovea were assessed preoperatively and at 1 wk, 1 and 3 mo postoperatively.

RESULTS:Among the 10 cases of PMF patients(10 eyes), the complete reattachment rate was 30%(3 eyes), while partial reattachment was observed in 70%(7 eyes). At 3 mo postoperatively, BCVA(LogMAR)was significantly improved to 0.957±0.393 compared with 1.432±0.509 before surgery(P<0.05), and both CFT(437.9±180.4 vs. 207.5±76.1 μm)and FS(686.5±172.2 vs. 290.7±86.6 μm)showed significant decreases(P<0.05). No complications such as macular hole, retinal detachment, silicone oil emulsification, or endophthalmitis were observed during the surgery or throughout the follow-up period.

CONCLUSION:PPV with SO tamponade and fovea-sparing ILM peeling has been demonstrated to facilitate both visual acuity improvement and anatomical reattachment in cases of PMF.