摘要内界膜(ILM)是视网膜Müller细胞的基底膜,由胶原纤维、粘多糖、层粘连蛋白和纤维粘连蛋白组成.由于ILM剥除(ILMP)手术可解除残留玻璃体皮质对黄斑区的牵拉,预防手术后黄斑区视网膜前膜形成,已被广泛用于治疗多种玻璃体视网膜疾病.但常规ILMP手术效果仍然存在一些不尽如人意之处,且有可能改变黄斑区正常生理结构和功能.故衍生出保留黄斑中心凹的ILMP以及各种形式的ILM填塞手术等一些改良的ILMP手术方式.目前在各种ILMP手术方式的临床应用、具体手术操作方法以及手术中染色剂的选择使用上仍存在一些值得关注改进的不确定之处.随着微创玻璃体切割手术在我国的广泛开展,充分认识ILMP手术在玻璃体视网膜疾病中应用的适应证,不断提高手术技巧,减少手术并发症所致的视功能损害是当前值得重视的问题.

abstractsThe internal limiting membrane (ILM),composed of collagen fibers,glycosaminoglycans,laminin and fibronectin,is the basement membrane of the retinal Müller glia cells and serves as an interface between the vitreous and retina.The ILM is the structural interface between the vitreous and retina.ILM removal ensures separation of the posterior hyaloid from the macular surface,which can relieve macular traction and prevent postoperative epiretinal membrane formation.Thus,vitrectomy with ILM peeling has become an increasingly utilized and vital component in surgical intervention for various vitreoretinal disorders.However,many recent studies showed that ILM peeling is a procedure that can cause immediate traumatic effects and progressive modification on the underlying inner retinal layers.There were some surgical strategy (fovea-sparing ILM peeling or inverted internal limiting membrane flap technique,or Abrasion Technique).But some controversies exist,such as when ILM peeling is necessary,which adjuvant to use to perform the procedure,and what is the best technique to peel the ILM.A full assessment ILM structure and function and related factors of surgery is helpful to predict the anatomical and functional prognosis.