RESIDUAL CELLULAR PROLIFERATION ON THE INTERNAL LIMITING MEMBRANE IN MACULAR PUCKER SURGERY
RESIDUAL CELLULAR PROLIFERATION ON THE INTERNAL LIMITING MEMBRANE IN MACULAR PUCKER SURGERY
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DOI：
10.1097/iae.0b013e3182246e2a
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发表时间：
2012-03-01
影响因子：
3.3
通讯作者：
Kampik, Anselm
中科院分区：
文献类型：
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作者：
Gandorfer, Arnd;Haritoglou, Christos;Kampik, Anselm
目的：为了提供病理学数据的完整性视网膜前膜（ERM）去除与不内界膜（ILM）peeling.Methods：22例特发性ERM形成的患者进行玻璃体切除与ERM去除和随后的染色的玻璃体黄斑界面与亮蓝。如果在ERM移除后ILM仍然存在，则将其剥离。将ERM和ILM标本收集在不同的容器中，并准备用于平板相差和干涉显微镜、免疫细胞化学和透射电子显微镜检查。结果：14例患者（64%）在ERM去除后，ILM仍然存在于黄斑处。平均而言，如果仅移除ERM，则总细胞计数的20%（范围，2-51%）留在ILM处。内界膜上主要为胶质细胞，透明细胞较少。在9只眼睛中，细胞正在形成细胞簇。8例患者（36%）同时切除了ERM和ILM。电子显微镜显示，在这些眼睛中，细胞增殖直接附着于ILM，而在顺序剥离组中，有胶原介于ERM和ILM之间。手术切除ERM导致分裂的玻璃体皮质在这些眼睛，留下的ILM与残留cells behind.Conclusion：简单的ERM去除结果在三分之一的情况下，只有足够的纤维细胞组织分离。在3例特发性ERM患者中，2例在移除ERM时玻璃体皮质分裂，在ILM上留下平均20%的总细胞计数。由于这些细胞能够增殖并导致ERM复发，因此在黄斑皱褶手术中对ILM进行染色并随后去除似乎是有益的。视网膜32：477-485，2012
Purpose: To provide pathology data on the completeness of epiretinal membrane (ERM) removal with and without internal limiting membrane (ILM) peeling.Methods: Twenty-two patients with idiopathic ERM formation underwent vitrectomy with ERM removal and subsequent staining of the vitreomacular interface with brilliant blue. If the ILM was still present after ERM removal, it was peeled off. Both ERM and ILM specimens were harvested in different containers and prepared for flat-mount phase-contrast and interference microscopy, immunocytochemistry, and transmission electron microscopy.Results: In 14 patients (64%), the ILM was still present at the macula after ERM removal. On average, 20% (range, 2-51%) of the total cell count was left behind at the ILM if the ERM was removed only. There were mainly glial cells on the ILM, and few hyalocytes. In nine eyes, the cells were forming cell clusters. In 8 patients (36%), both ERM and ILM were removed together. Electron microscopy showed cellular proliferation directly attached to the ILM in these eyes, whereas in the sequentially peeled group, there was collagen interposed between the ERM and the ILM. Surgical ERM removal resulted in splitting of the vitreous cortex in these eyes, leaving the ILM with residual cells behind.Conclusion: Simple ERM removal results in sufficient separation of fibrocellular tissue in one third of cases, only. In 2 of 3 patients with idiopathic ERM, the vitreous cortex splits when the ERM is removed, leaving an average of 20% of the total cell count behind on the ILM. As these cells are capable of proliferation and causing ERM recurrence, staining of the ILM with subsequent removal seems beneficial in macular pucker surgery. RETINA 32: 477-485, 2012