本视频为2025年10月于山西省眼科医院所开展的玻璃体视网膜相关院基培训的手术范例之七。
在本视频中，Hendrick医生与学员为一名左眼黄斑裂孔，且有双眼老年性白内障的60岁女性患者，施行了玻璃体切除术合并白内障超声乳化和IOL植入。
手术地点：山西省眼科医院，太原，山西省，中国
手术医生：Andrew M. Hendrick医生，埃默里大学 (Emory University)，美国
Transcript
0:00 This is a phakic macular hole. We decide to perform phaco vitrectomy and place the cannulas first. The phaco and IOL proceed without incident. Avoid large capsulorrhexis when combining cases that involve vitreous substitutes like oil and case to reduce risk of IOL dislocation.
该病例为有晶状体的黄斑裂孔。我们决定先行白内障超声乳化联合玻璃体切除术，并首先放置套管。白内障超声乳化及人工晶状体植入术顺利完成。在联合应用玻璃体替代物（如硅油）及其他相关操作时，应避免过大的囊膜环形撕开，以降低人工晶状体脱位的风险。
3:49 Core vitrectomy is performed. Patients with macular holes rarely have PVD unless chronic.
首先进行核心玻璃体切除。除慢性病例外，黄斑裂孔患者通常不伴有玻璃体后脱离。
4:16 After core PPV, I induced PVD using the vitrectomy cutter. I try to deliver it past the equator and allow the vitreous to separate gradually as forceful delivery of the hyaloid can introduce retinal breaks.
核心玻璃体切除术后，我利用玻切头诱导玻璃体后脱离。操作时，我尝试将后界膜剥离至视网膜赤道部，并使玻璃体自然逐渐分离，以避免用力牵拉玻璃体后界膜导致视网膜裂孔发生。
5:34 Air fluid exchange is needed when using ICG as the ILM stain.
如采用ICG作为内界膜染色剂，则需行气液交换。
6:27 I typically allow 1 minute of staining before removing the dye and refilling with saline. In this case, the staining is quite robust.
通常染色持续1分钟后，去除染料并用生理盐水重新充填玻璃腔。本例中，染色效果较为明显。
7:27 We are now looking through a contact lens for high magnification. Hemorrhages are common with the initial ILM incision. This ILM is quite stiff and peels remarkably in one broad sheet.
现在通过接触镜进行高倍显微观察。切开内界膜初期常见出血现象。该内界膜较为坚韧，可整体成片剥离。
8:20 Gentle scleral depression is conducted with peripheral gel shaving. A final air fluid exchange and gas is substituted in the vitreous cavity.
在进行周边玻璃体修整的同时，实施轻柔的巩膜压迫。最后进行气液交换，并在玻璃体腔内置换气体。