3　临床随访

　　Kaplan等［28］报道2例用感光细胞片植入无光感的视网膜色素上皮变性患者的黄斑区视网膜下腔，未用任何免疫抑制剂，随访中未发现免疫排斥反应，也无黄斑囊样水肿、葡萄膜炎、黄斑皱褶等并发症，但视力仍无光感。而Das等［29］也进行了这方面的应用研究，将人胚胎视网膜层植入14例视网膜色素上皮变性患者的黄斑区视网膜下腔，5例进行10～34mo的观察，结果2例视力从光感到手动，1例从光感到数指，1例从CF/1/3m到CF/2/3m，另1例患者在5度视野内从光感到20/200，ERG及视野检查无任何改变，视网膜下腔情况同Kaplan报道。

　　以上资料可以证明，视网膜下腔可以安全的进行视网膜移植，不会产生任何并发症，尽管植入后ERG没有改变，视功能无明显提高，但并不意味着移植失败，因为正常的视觉是一个复杂的电生理过程，必须有足够的感光细胞受到刺激才能产生视觉，目前的移植方法可能达不到有效的感光细胞数目，因而目前的检测方法可能检测不到。

　　4　展望

　　视网膜移植及再生是治疗某些眼底病的可行方法，但植片的生长存活必须在适宜的微环境中进行，还需一些成长因子的作用，同时还要抑制感光细胞的丢失，随着分子生物学的进展，可以利用调控基因的方法，促进细胞的生长发育，使其恢复功能，当然，在临床应用之前，还需做大量的研究工作。

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