重硅油填充在下方裂孔的视网膜脱离术中应用  

Heavy silicone oil tamponade for rhegmatogenous retinal detachment with inferior retinal tear

作　　者：李强[1] 孙力[1] 陈诗兰[1] 

机构地区：[1]广州市花都区人民医院,广州510800

出　　处：《中华眼外伤职业眼病杂志》2012年第7期521-523,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价重硅油眼内填充治疗下方裂孔的视网膜脱离手术疗效及并发症。方法对下方视网膜裂孔和严重增生性玻璃体视网膜病变（PVR）的复杂性视网膜脱离15例（15眼）行玻璃体切除联合玻璃体腔重硅油填充术。并同时选取15眼患相似类型的视网膜脱离者，在玻璃体切除术后给予眼内普通轻硅油填充作为对照。硅油取出的时间：重硅油组为手术后21-99d，轻硅油组为32-108d。两组时间比较，P〉0．05。术后对视力、眼压及并发症等情况进行随访。结果随访8-13个月，重硅油组视网膜一次完全复位者13眼（86．67％），轻硅油组一次视网膜完全复位者9眼（60．00％）（P〈0．05），重硅油组并发症有：并发性白内障7眼，重硅油乳化4眼，高眼压3眼，严重的前房炎症反应1眼。结论对下方裂孔的视网膜脱离行玻璃体切除联合玻璃体腔重硅油填充术，可获得良好的视网膜复位率，可提高因为年龄或全身因素无法俯卧患者的舒适性。并发症主要为并发性白内障，高眼压，硅油乳化，前房炎症反应，经过适当处理均可解决。Objective To evaluate the curative effect and complications of heavy silicone oil tampe- nade for rhegmatogenous retinal detachment with inferior retinal tear. Methods Fifteen eases （ 15 eyes） of serious retinal detachment with inferior retinal tear or PVR had accepted vitrectomy and heavy silicone oil tamponade. At the same time, randomly 15 eyes with similar type of retinal datachment accepted vitrectomy and routine silicone oil tamponade as the control group. The silicone oil extraction was performed 21 -99 days after surgery in heavy silicone oil group, it was 32 - 108 days in control group （P 〈0.05）. Postopera- tive visual acuity, intraocular pressure （IOP） and complications were observed. Results The follow-up was 8 to 13 months, The retina reattached in 13 eyes （86. 67% ） in heavy silicone oil group, and 9 eyes （60.00%） in control group （ P 〈 0. 05 ）. The main complications of heavy silicone oil group were compli- cated cataract in 7 cases, heavy silicone oil emulsification in 4 cases, high intraocular pressure in 3 cases, serious anterior chamber inflammation in one case. Conclusion For patients of retinal detachment with in- ferior retinal tear, vitrectomy combined with heavy silicone oil tamponade could obtain satisfactory retinal re- attachment rate, it can improve comfortable for patients with high age or systemic factors that could not main- tain prone position. The main complications were complicated cataract, high intraocular pressure, silicone oil emulsification and anterior chamber inflammation.

关 键 词：硅油 重 填充 脱离 视网膜 

分 类 号：R779.6[医药卫生—眼科]