摘要目的:观察继发性黄斑前膜的病因及治疗效果。方法:回顾性病例系列研究。纳入郑州大学第一附属医院眼科2020年1月至2021年12月收治的黄斑前膜患者149例(149眼)。术前完善眼部相关检查查找病因，共纳入继发性黄斑前膜95例(95眼)。病因包括：视网膜血管增生性肿瘤2例，眼外伤相关眼病3例，弓蛔虫感染3例，视网膜静脉阻塞4例，高度近视7例，白内障术后7例，葡萄膜炎9例，糖尿病相关13例，视网膜脱离玻璃体切除术后14例，视网膜周边裂孔及病变33例。所有患者均先治疗原发病，除1眼经治疗黄斑前膜自愈外，其余94眼待原发病稳定后行玻璃体切除联合黄斑前膜及视网膜内界膜剥除术。术后随访6~18个月，观察比较继发性黄斑前膜的发病情况，手术前后视力分布、黄斑中心区厚度(CMT)、微视野及术后并发症。结果:术后6个月视力分布与术前相比，差异有统计学意义( χ2＝24.09， P<0.001)。CMT术后(256.72±46.00)μm较术前(457.98±88.61)μm降低( t＝26.01, P<0.001)。视网膜平均光敏感度(MLS)术后(21.36±5.90)dB较术前(17.67±6.43)dB改善( t＝－13.74， P<0.001)。本组患者治愈92例，治愈率96.84%(92/95)。 结论:继发性黄斑前膜术前排查病因，在活动性原发病控制后行手术治疗能有效提高视力，减少并发症。

abstractsObjective:To observe the pathogenesis and therapeutic efficacy of secondary macular epiretinal membrane (MEM).Methods:This was a retrospective case series study. A total of 149 patients (149 eyes) with macular epiretinal membrane were included in the First Affiliated Hospital of Zhengzhou University from Jan. 2020 to Dec. 2021. After a complete preoperative examination for all patients to find the primary disease, 95 patients (95 eyes) with secondary MEM were included. The etiology included 2 cases of retinal vascular proliferative tumors, 3 cases of ocular trauma, 3 cases of toxocara infection, 4 cases of retinal vein occlusion, 7 cases of high myopia, 7 cases of cataract surgery, 9 cases of uveitis, 13 cases of diabetes, 14 cases of retinal detachment after vitrectomy, and 33 cases of retinal peripheral holes and lesions. All patients were treated for the active primary disease firstly, then 94 eyes underwent vitrectomy combined with MEM and internal limiting membrane peeling except for 1 eye whose MEM separated spontaneously after laser treatment. The follow-up examinations were performed for 6 to 18 months after operation to observe and compare the etiology and incidence of different secondary MEM, visual distribution, the central macular thickness (CMT), the microscopic field and postoperative complications.Results:The postoperative visual distribution at 6 months after surgery was significantly different from that before surgery ( χ2=24.09, P<0.001). The CMT decreased from (457.98±88.61)μm before operation to (256.72±46.00)μm after operation ( t=26.01, P<0.001). The mean retinal light sensitivity (MLS) significantly improved from (17.67±6.43)dB before surgery to (21.36±5.90)dB after surgery ( t=-13.74, P<0.001). In this group, 92 patients were cured with a cure rate at 96.84% (92/95). Conclusion:By screening and stabilizing the primary disease of secondary MEM before operation, the visual function of patients effectively improves and postoperative complications can be reduced.