方法：2010-01/2012-12因增生性玻璃体视网膜病变行手术患者48例纳入研究； 患者分为两组：内界膜剥离组(A组)23例，未行内界膜剥离组(B组)25例。所有患者均首次行玻璃体切割手术并硅油填充，术后定期复诊，成功取出硅油，视网膜复位成功。对比观察患者手术前术后裂隙灯、光学相干断层扫描(OCT)、最佳矫正视力检查结果。统计采用独立样本t检验、配对样本t检验、Fisher's确切概率法、Pearson卡方检验对所记录数据分析，P≤0.05为差异有统计学意义。

结果：A组患者玻璃体切割术后复查发现1例产生继发性视网膜前膜； B组发现7例产生继发性视网膜前膜，结果比较具有统计学意义(P< 0.05)； A组硅油取出后黄斑中心厚度(CMT)188.36±45.53μm，B组220.42±53.15μm，两者比较具有统计学意义(P< 0.05)； 内界膜剥离组患者黄斑水肿较轻，OCT显示黄斑区形态更接近于正常； 患者治疗结束后logMAR视力A组1.38±0.60，B组1.61±0.51，两者比较不具统计学意义。

结论：内界膜剥离术能够预防继发性视网膜前膜的产生，有利于视网膜结构的恢复，临床医生可以在PVR患者的玻璃体切割手术中考虑使用内界膜剥离技术。

METHODS: Totally 48 cases with serious PVR underwent vitrectomy were enrolled in this study. All these cases were divided into two groups: 23 cases in group A underwent vitrectomy with ILM peeling; 25 cases in group B underwent vitrectomy without ILM peeling. All patients underwent successful primary vitrectomy using silicone oil. After regular referral, silicone oil was removed, the retina reattached successfully. The results of slit lamp, optical coherence tomography(OCT), best corrected logarithm of minimal angle of resolution(logMAR)visual acuity pre and post operation and secondary epimacular membrane formation were observed and contrasted. Independent sample t-test, paired sample t-test, Pearson Chi-square test and Fisher's Exact test were used to analyze the significance of results with a P value ≤0.05 interpreted as statistically significance.

RESULTS: Secondary epimacular membrane formation was found in one eye in group A, and seven eyes in group B after vitrectomy, the difference was significant. Central macular thickness was 188.36±45.53μm in group A, and 220.42±53.15μm in group B after the removal of silicone oil, the difference was significant. Macular edema was comparatively mild in group with ILM peeling. Image of macular morphology in OCT was more similar to the normal in group A. The final logMAR visual acuity was 1.38±0.60 in group A and 1.61±0.51 in group B, the difference was not significant between these two groups.

CONCLUSION: ILM peeling may prevent the formation of secondary epiretinal membrane, is conducive to the recovery of retinal structure. This technology can be used in vitrectomy for PVR.