脉络膜是一层薄薄的富含血管的葡萄膜组织，外部被巩膜包围，内部被神经感觉视网膜组织包围。脉络膜是一种“中层”眼组织，在解剖学上具有挑战性的手术通道。脉络膜的主要功能作用是向高度代谢的视网膜色素上皮和外视网膜（即光感受器）提供快速、含氧和营养丰富的血流，同时清除废物。历史上，脉络膜切开手术（ICS）涉及肿瘤活检或切除、脉络膜新生血管复合体切除或自体脉络膜易位；然而，ICS 在解决黄斑病理学的新颖和创新方法方面也具有独特的潜力。通过大型动物手术研究，研究人员对 ICS 进行了探索，目的是找到更安全、更有效的技术来降低手术风险，例如出血、组织收缩和疤痕组织形成。我们探索相关的解剖学和胚胎学、现有的手术技术，讨论对视网膜药物输送的影响，定义 ICS 指导原则，并提供在玻璃体视网膜手术实践中实施 ICS 的基本原理。我们还确定了未来的其他挑战，并预测了将推动 ICS 发展的未来创新。版权所有 © 2024 Elsevier Inc. 保留所有权利。

The choroid is a thin layer of highly vascular uveal tissue enclosed externally by sclera and internally by neurosensory retinal tissue. The choroid is a "middle layer" ocular tissue with anatomically challenging surgical access. The primary functional role of the choroid is to provide rapid, oxygenated, and nutrient-rich blood flow to both the highly metabolic retinal pigment epithelium and outer retina (i.e. photoreceptors) while simultaneously removing waste products. Historically, incisional choroidal surgery (ICS) has involved tumor biopsy or excision, removal of choroidal neovascular complex or autologous choroidal translocations; however, ICS also holds unique potential for novel and innovative approaches to address macular pathology. Using large-animal surgical studies, researchers have explored ICS with the objective of finding safer and more effective techniques to reduce surgical risks such as bleeding, tissue contraction, and scar tissue formation. We explore the relevant anatomy and embryology, existing surgical techniques, discuss the implications for retinal drug delivery, define ICS guiding principles, and offer a rationale for implementation of ICS into a vitreoretinal surgical practice. We also identify other future challenges and anticipate future innovations that will advance ICS.Copyright © 2024 Elsevier Inc. All rights reserved.