早期取出硅油的原因和手术效果  

The reason and effect of early silicone oil removal

作　　者：苏定旺 刘文[2] 钟刘学颖 钟丘 岑志敏 

机构地区：[1]广东省中山火炬开发区医院,528437 [2]中山大学中山眼科中心,510060

出　　处：《中国实用眼科杂志》2014年第11期1360-1363,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨提前取出硅油的原因和再次手术后的效果.方法 对2005年1月至2012年6月在中山眼科中心,选择硅油注入眼内不足2个月（61天）并有完整病例资料的36例（36只眼）,提前行硅油取出原因及再次手术后效果.术后随访≥6个月,记录患者最佳矫正视力、眼压及视网膜复位情况.结果 提前硅油取出原因中视网膜未复位18只眼（50％,18/36）;难以控制的高眼压8只眼（22.2％,8/36）;黄斑前膜4只眼（11.1％,4/36）;硅油入前房或者硅油乳化5只眼（13.9％,5/36）;眼内出血1只眼（2.8％,1/36）.术后视力提高者22只眼（占61.1％,22/36）,不变者9只眼（占25％,9/36）,5只眼（占13.9％,5/36）轻度下降.高眼压原因（8只眼）取油者术前平均眼压（36.54±11.35） mmHg,术后平均眼压（13.13±6.93） mmHg,差异有统计学意义（P＜0.01）.共6只眼术后发生视网膜脱离,再次手术后4只眼视网膜复位,总复位率为94.4％ （34/36）.结论 早期硅油取出的原因主要是视网膜脱离和难以控制的高眼压,其他是黄斑前膜和硅油入前房和乳化,及时取出硅油和处理原发原因,可挽救患者视功能.Objective To investigate the reason and effect of early silicone oil removal.Methods A total of 526 cases （526 eyes） with silicone oil removal from January 2005 to June 2012 were reviewed.Among them,36 cases （36 eyes） that were removed silicone oil less than two months （61 days） and had complete clinical data were selected.The reason and effect of silicone oil removal for the 36 cases （36 eyes） were analyzed retrospectively.All of the cases were followed up for more than 6 months.The best corrected visual acuity,intraocular pressure and reattachment of retina were recorded.Results The reason of early silicone oil removal included retinal detachment （18 eyes,50％,18/36）,high intraocular pressure （8 eyes,22.2％,8/36）,macular epiretinal membrane （4 eyes,11.1％,4/36）,silicone oil into the anterior chamber or emulsification （5 eyes,13.9％,5/36） and intraocular hemorrhage （1 eye,2.8％,1/36）.Best corrected visual acuity improved in 22 eyes （61.1％,22/36）,stabled in 9 eyes （25％,9/36） and descended in 5 eyes （13.9％,5/36）.The average intraocular pressure of 8 eyes with high intraocular pressure was 13.13±6.93mmHg compared with that before operation （36.54±11.35mmHg）.There was significant difference （P ＜0.01）.Recurrent retinal detachment came out for 6 eyes and retina was reattached for 4 eyes after the second operation.The total effective rate was 94.4％ （34/36）.Conclusions Retinal detachment and high intraocular pressure are the main reasons why silicone oil is removed earlier.Macular preretinal membrane and silicone oil into the anterior chamber or emulsified may also be reasons.Removing silicone oil timely and dealing with the primary reasons can save visual function.

关 键 词：硅油填充眼 玻璃体手术 视网膜脱离 并发症 增生性玻璃体视网膜病变(PVR) 

分 类 号：R774.12[医药卫生—眼科]