方法：回顾性病例研究。收集2013-07/2017-11在我院就诊，屈光度数≥-6.00D，眼轴长度≥26mm，经眼底检查确诊为高度近视MHRD的患者27例27眼，其中男9例9眼，女18例18眼，年龄41～70(平均53.69±7.23)岁，最佳矫正视力(best-corrected visual acuity，BCVA)为1.41±0.28(LogMAR)。所有患者均行经睫状体平坦部23G玻璃体切割术，伴有晶状体混浊影响手术者同时行晶状体咬切术。术中彻底切除玻璃体后皮质，亮蓝G染色黄斑区ILM，环形剥除黄斑中心凹周围血管弓内ILM，残留黄斑裂孔(MH)边缘少量ILM，将其反转覆盖于MH上，并行C₃F₈或硅油填充。平均随访时间6mo以上。观察所有患者末次随访时BCVA、MH闭合、视网膜复位和眼部并发症情况。

结果：患者术后BCVA提高21眼(78%)，视力不变4眼(15%)，视力下降2眼(7%)。平均BCVA为0.84±0.40(LogMAR)，与术前比较差异有统计学意义(t=7.32，P<0.05)。术后MH闭合24眼(89%)，视网膜解剖复位25眼(93%)，所有患者无严重眼部和全身并发症。

结论：PPV联合ILM覆盖术治疗高度近视MHRD安全有效，可改善视力，裂孔闭合率、视网膜复位率高。

METHODS: This was a retrospective case series. Totally 27 patients(27 eyes)who were diagnosised with MHRD of high myopia and underwent vitrectomy combined with inverted ILM flap covering technique were eIlrolled in this study. The diopter was ≥-6.00D and axial length was ≥26mm. The mean age was 53.69±7.23 years. And there 9 males and 18 females. The logarithm of the minimum angle of resolution(LogMAR)best-corrected visual acuity(BCVA)was 1.41±0.28. All patients were performed PPV with inverted ILM flap, resected the vitreous gel and cortex completely. Bright blue G stained the ILM around the fovea. The ILM was peeled off around the MH, and some portion of the ILM flap was left attached to the edge of the MH. Covering the MH with the ILM flap.Then, C₃F₈ gas or silicone oil was injected into the vitreous cavity. The mean follow-up was more than 6mo and BCVA, MH closure, retinal reattachment, complications were retrospectively observed.

RESULTS: After surgery, visual acuity improved in 21 eyes(78%), unchanged in 4 eyes(15%), decreased in 2 eyes(7%). The mean LogMAR BCVA was 0.84±0.40, the difference was significant(t=7.32, P<0.05). The macular hole closure rate was 89%(24 eyes)and retinal reattachment rate was 93%(25 eyes). No severe complicationwas observed.

CONCLUSION: PPV combined with inverted internal limiting membrane flap is an effective and safe management for the MHRD of high myopia.