Studies on the mechanisms of sensory retinal adhesion, its breakdown and reconstruction

对S连续110眼特发性黄斑裂孔玻璃体切除手术的疗效进行了研究。孔洞闭合率达90%。在实验性兔眼视网膜HOHE中，感觉性视网膜和RPE的早期附着是闭合的关键，其中胶质细胞和RPE细胞起重要作用。18只眼表现为视野缺陷，总是位于输液插管的对侧。这种视野缺陷的发生率受输液气压的影响很大。用兔眼评价气压对视网膜的损伤。扫描电子显微镜下，在输液插管的对侧可观察到边界清晰的视网膜病变。内界膜常脱落，暴露神经纤维层。我们得出结论，视野缺陷的原因是输液气压对视网膜的机械性损伤。眼底的变化是进行性的，所以对视野缺陷的眼睛进行几年的随访检查是很重要的。

We studied the result s of vitrectomy for consecutive 110 eyes with idiopathic macular hole. Closure of hole was achieved in 90%. In experimental retinal hohe of rabbits eyes, early attachment of sensory retina and RPE was essential for closure, and glial and RPE cells played an important roles. Eighteen eyes showed visual field defects, which was always located contralateral to the infusion cannula. The incidence of this visual field defect was influenced strongly by the infusion air pressure. The retinal damage by air pressure was evaluated in rabbit eyes. Sharply demarcated retinal lesions were observed at the opposite side from the infusion cannula with SEM. The internal limitimg membrane was often detached, and the underlying nerve fiber layer was exposed. We concluded the cause of visual field defect was mechanical retinal damage by infusion air pressure. The fundus changes were progressive, so it is important to examine eyes with visual field defect for a follow-up period of several years.