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目的:观察并分析累及黄斑的孔源性视网膜脱离（RRD）患眼玻璃体切割手术（PPV）后视物变形程度（M）及其与黄斑微结构改变的相关性。方法:回顾性临床研究。2017年1月至2019年1月于保定市第一中心医院检查确诊的累及黄斑RRD患者57例57只眼纳入研究。所有患者均行经睫状体平坦部标准23G PPV。首次PPV后视网膜解剖复位。PPV前及手术后1、6、12个月，行最佳矫正视力（BCVA ）、眼压、裂隙灯显微镜、间接检眼镜、视物变形、光相干断层扫描（OCT）检查。采用国际标准视力表行BCVA检查，统计时换算为最小分辨角对数（logMAR）视力。采用OCT仪测量黄斑中心凹视网膜厚度（CRT ），同时记录黄斑区微结构改变包括是否存在黄斑前膜（ERM ）、黄斑囊样水肿（CME）、视网膜下液（SRF）以及椭圆体带（EZ）和外界膜（ELM）的完整性。应用M-chart表进行M检查。分析手术前后BCVA、M值变化及与黄斑区微结构改变之间的相关性。BCVA和M值之间的相关性采用Pearson相关性分析；黄斑区微结构改变与BCVA、M值的相关性采用Spearman相关性分析。结果:手术前及手术后1、6、12个月，患眼平均logMAR BCVA分别为1.15±0.43、0.62±0.17、0.39±0.18、0.34±0.13，患眼手术后视力较手术前明显改善，差异有统计学意义（n F=119.731 ，n P＝0.000 ）；平均CRT分别为（476.0±104.1）、（299.8±29.9）、（272.2±17.8）、（261.0±19.3）μm，手术后CRT均较手术前明显下降，差异有统计学意义（n F=185.518，n P=0.000 ）。手术后1、6、12个月，患眼平均M值分别为0.62±0.54、0.43±0.41、0.32±0.36；不同时间平均M值比较，差异有统计学意义（n F=6.568，n P=0.020 ）。手术后，存在黄斑区微结构异常48只眼（84.2%，48/57 ），包括EZ和ELM完整性中断、SRF、CME、ERM。相关性分析结果显示，手术后M值与手术前BCVA、CRT、SRF高度呈明显正相关（n r/n rn s=0.672、0.385、0.932，n P0.05）。n 结论:累及黄斑的RRD PPV后BCVA明显提高，M逐渐减轻；手术后M值与手术前BCVA、CRT、SRF高度相关。“,”Objective:To evaluate the changes of metamorphopsia in patients with rhegmatogenous retinal detachment (RRD) who underwent primary vitrectomy and to analyze the correlation between macular microstructure changes and metamorphopsia.Methods:It was a retrospective clinical study. From January 2017 to January 2019, 57 patients (57 eyes) with RRD were examined and diagnosed in the Department of Ophthalmology of Baoding First Central Hospital were enrolled in this study. All patients underwent 23G PPV. All patients had retinal anatomical reduction after the first PPV. The best corrected visual acuity (BCVA), intraocular pressure, slit-lamp microscope, indirect ophthalmoscope, changes of metamorphopsia, and optical coherence tomography (OCT) were examined before PPV and 1, 6, 12 months after the operation. The BCVA examination was performed using the international standard visual acuity chart, which was converted into a logarithm of the minimum angle of resolution (logMAR) BCVA for the record. The macular fovea retinal thickness (CRT) was measured by Carl Zeiss Cirrus HD-OCT5000 instrument from Carl Zeiss Company, Germany, and the microstructural changes in the macular area were recorded, including the presence of the anterior macular membrane (ERM), cystic macular edema (CME), subretinal fluid (SRF), and the integrity of the ellipsoid zone (EZ) and outer membrane (ELM). The value of metamorphopsia (M value) was measured by the M-Chart table. The changes of BCVA, M value, and the microstructure of the macular area before and after operation were analyzed. The correlation between BCVA and M value was analyzed by Pearson correlation. Spearman correlation analysis was used to analyze the correlation between the changes of macular microstructure and BCVA and M values.Results:The mean logMAR BCVA before the operation was 1.15±0.43. At 1, 6, and 12 months after the operation, the mean logMAR BCVA was 0.62±0.17, 0.39±0.18, and 0.34±0.13, respectively. The visual acuity improved significantly after operation compared with before operation, and the difference was statistically significant (n F=119.731, n P=0.000). The mean CRT before the operation was 476.0±104.1 μm. At 1, 6, and 12 months after the operation, the average CRT were 299.8±29.9, 272.2±17.8, and 261.0±19.3 μm, respectively. The average CRT after the operation was significantly lower than those before the operation ( n F=185.518, n P=0.000). At 1, 6, and 12 months after the operation, the mean M values were 0.62±0.54, 0.43±0.41, and 0.32±0.36, respectively; the difference was statistically significant (n F=6.568, n P=0.020). After the operation, 48 eyes (84.2%, 48/57) had microstructural abnormalities in the macular area, including EZ and ELM integrity disruption, SRF, CME, and ERM. Correlation analysis showed that M value was significantly positively correlated with BCVA, CRT, and SRF height before operation (n r/n rs=0.672, 0.385, 0.932; n P0.05).n Conclusions:The BCVA is significantly increased and the metamorphopsia is improved after anatomically successful RRD surgery. Postoperative M value is highly correlated with preoperative BCVA, CRT, and SRF.