重硅油在复杂眼外伤玻璃体切割术中的初步应用  

Preliminary application of heavy silicone oil in vitrectomy for complicated ocular trauma

作　　者：万光明[1] 陈仕建[1] 

机构地区：[1]郑州大学第一附属医院眼科,河南省高等学校临床医学重点学科开放实验室,河南省郑州市450052

出　　处：《眼科新进展》2011年第7期645-647,共3页Recent Advances in Ophthalmology

基　　金：河南省杰出青年基金资助(编号:512000600)~~

摘　　要：目的探讨重硅油Densiron-68在复杂眼外伤玻璃体切割术中的应用及疗效。方法 复杂眼外伤患者9例(9眼),所有患眼玻璃体切割术中均可见后极部或下方视网膜裂孔,其中裂孔周围合并明显出血或增生机化者6眼。裂孔紧邻视盘者2眼(分别位于视盘鼻侧及下方),裂孔位于黄斑区者4眼,下方裂孔3眼(裂孔均大于1.5PD并伴明显增生机化),均行适量激光光凝,并给予Densiron-68注入。观察术后眼部情况,如视网膜复位情况、视力、眼压等。结果 所有患眼术前3d及术后1周时眼压均正常;术后2周时平均眼压为36.53mmHg(1kPa=7.5mmHg),其中5眼应用降眼压药物不能控制眼压,行前房穿刺。术后1周平均矫正视力为0.04,术后2周为0.05,术后4周为0.08,较术前提高。重硅油取出时间为术后16～41d,平均32d;5眼可观察到硅油乳化现象,最早1眼为术后15d。所有患眼视网膜复位均良好。结论 重硅油填充眼极易发生眼压升高,而且重硅油乳化时间出现较早;重硅油的应用应严格控制适应证,仅应用于不能俯卧位的患者。Objective To investigate the effect of clinical application of heavy silicone oil in vitrectomy for complicated ocular trauma. Methods Nine patients （9 eyes） were with complicated ocular trauma, all eyes were seen the retinal tear in the posterior pole or in the inferior part. Six eyes were with obvious haemorrhage and proliferation around the retinal tear. Retinal tears of 2 eyes closed to the optic disc （ 1 located at inferior and another at nasal） ,4 eyes in the macular area,and 3 in the inferior retina （ all tears were larger than 1.5 PD and accompanied with obvious proliferation）. Appropriate laser photocoagulation was performed, and the heavy silicone oil was used. Postoperative condition such as retinal reattachment, visual acuity and intraocular pressure were observed. Results Intraocular pressure was normal in all eyes at preoperative 3 days and postoperative 1 week. It was 35.53 mmHg （ 1 kPa =7.5 mmHg） at post-operative 2 weeks. Intraocular pressure of 5 eyes couldn＇ t control with drugs to decrease and treated with paracentesis of anterior chamber. The average corrected visual acuities were 0.04,0.05 and 0.08 at postoperative 1 week, 2 weeks and 4 weeks, higher than that at pre-operation. Heavy silicone oil was taken out at postoperative 16 days to 41 days,averaged in 32 days. Five eyes with silicone oil emulsion and first appeared in 1 eye at postoperative 15 days. Retinal reposition was well in all eyes. Conclusions With heavy silicone oil, the elevation of intraocular pressure occurres easily and the emulsification time appears earlier; Heavy silicone oil application indications should be strictly controlled, only used to the patients who can not lie in prone position.

关 键 词：重硅油 玻璃体切割术 眼外伤 

分 类 号：R779[医药卫生—眼科]