硅油取出手术后视网膜再脱离原因分析  

Etiology study of retinal detachment after silicone oil removal

作　　者：魏晓雯 姚毅[2] 

机构地区：[1]解放军第463医院眼科 [2]解放军总医院眼科,北京100853

出　　处：《中华眼底病杂志》2014年第4期366-368,共3页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的 观察硅油取出手术后视网膜再脱离的发生率,探讨其可能的原因.方法 回顾性分析2008年至2012年在解放军总医院眼科行硅油取出手术的821例患者858只眼的临床资料.其中,男性518例,女性303例;年龄1～79岁,平均年龄44.03岁.患者均为玻璃体切割联合硅油填充手术后完成硅油取出手术者.硅油填充时间40 d～13年,平均硅油填充时间6.82个月.回顾分析手术后视网膜再脱离的发生率及发生时间.结果 821例858只眼中,发生视网膜再脱离43例44只眼,占所有患眼的5.13％.硅油取出手术后视网膜再次脱离时间,1周内23只眼,占52.27％;1～4周内13只眼,占29.55％;4～8周内4只眼,占9.08％;8～12周2只眼,占4.55％;12周以上2只眼,占4.55％.视网膜再脱离原因,原视网膜裂孔复发7只眼;周边玻璃体残留3只眼;增生膜形成,牵拉性视网膜脱离18只眼;新发生视网膜裂孔 9只眼;原视网膜裂孔封闭不良5只眼;视网膜嵌塞于巩膜穿刺口处,牵拉性视网膜脱离2只眼.结论 硅油取出手术后视网膜再脱离发生率为5.13％;视网膜再脱离的主要原因是硅油填充时间和手术者因素.Objective To evaluate the incidence of retinal re-detachment and possible risk factors after removal of silicone oil.Methods The clinical data of 821 patients （858 eyes） who underwent removal of silicone oil in General Hospital of PLA during 2008-2012 were retrospectively analyzed.The patients included 518 males and 303 females.The age was ranged from 1 to 79 years old,with an average of 44.03 years.All patients underwent removal of silicone oil after vitrectomy combined with silicone oil tamponade （the tamponade period was ranged from 40 days to 13 years,with an average of 6.82 months）.The incidence,time and causes of retinal re-detachment were analyzed.Results Retinal re-detachment occurred in43 patients （44 eyes,5.13％）.Among these retinal re-detachment in 44 eyes,23 eyes （52.27％） occurred in 1 week,13 eyes （29.55％） in 1-4 weeks,4 eyes （9.08％） in 4-8 weeks,2 eyes （4.55％） in 8-12 weeks,and 2 eyes （4.55％） more than 12 weeks after silicone oil removal.Possible reasons of retinal re-detachment included activated original retinal holes （7 eyes）,residual peripheral vitreous （3 eyes）,traction of epiretinal proliferative membrane （18 eyes）,new retinal hole （9 eyes）,non-closure of original retinal holes （5 eyes） and traction of retinal incarceration in the scleral incision （2 eyes）.Conclusions The incidence of retinal re-detachment after silicone oil removal is 5.13 ％.The incidence reduced gradually with the extension of time after removal silicone oil.

关 键 词：视网膜脱离 病因学 硅油类 

分 类 号：R779.6[医药卫生—眼科]