改良25G硅油取出术临床观察  

Clinical observation of silicone oil removal via improved 25-gauge incision

作　　者：陈忠平[1,2] 陈娟[1] 段毅琴[1,2] 王启常[1,2] 唐仕波[1,2] 

机构地区：[1]长沙爱尔眼科医院眼底病科,湖南410015 [2]中南大学爱尔眼科学院

出　　处：《中国实用眼科杂志》2016年第2期126-129,共4页Chinese Journal of Practical Ophthalmology

基　　金：爱尔眼科医院集团科研基金项目（AF141201）;长沙市科技计划项目（K1203037-31）;湖南省卫生计生委课题（C2015-69）

摘　　要：目的比较改良三通道25G硅油取出术和三通道23G硅油取出术的临床效果及手术安全性。方法临床病例对照研究。选择2013年1-12月在长沙爱尔眼科医院网膜复位良好、行硅油取出术的病人依切口分为两组：A组为改良25G切口硅油取出术组、B组为23G切口硅油取出术组。两组均采用三通道，A组颞下方、左上方放置25G套管，右上方做20G切口；B组三通道均放置23G套管。A组63例（63只眼），无晶状体眼17只眼，人工晶状体眼9只眼，有晶状体眼37只眼。其中硅油取出＋超声乳化＋人工晶状体植入23只眼，硅油取出＋二期人工晶状体植入9只眼（其中晶状体悬吊5只眼），硅油取出＋剥膜＋C3F8眼内充填8只眼，单纯硅油取出23只眼。硅油眼内存留时间3-13月，平均（4．7±3．3）月；术前视力：光感-0．2，术前眼压：7-38mmHg，硅油乳化4只眼。B组66例（66只眼），无晶状体眼15只眼，人工晶状体眼8只眼，有晶状体眼43只眼。硅油取出＋超声乳化＋人工晶状体植入21只眼，硅油取出＋二期人工晶状体植入8只眼（其中晶状体悬吊5只眼），单纯硅油取出37只眼。硅油眼内存留时间3-14月，平均（5.3±3．5）月。结果A组与B组平均手术时间分别为（36．53±9．67）min及（39．82±10．26）min，两组差异无统计学意义（t=1．137，P〉0．05）。A组视力提高38只眼、不变17只眼、降低8只眼，B组提高36只眼、不变19只眼、降低11只眼。两组之间差别无统计学意义（χ^2=0．569，P〉0．05）。A组与B组术后眼部不适感持续时问分别为（5．14±2．22）天及（7．23±2．72）天，两组差异有统计学意义（t=4．753，P=0．00）。术后硅油残留者，A组为0例，B组为3例（z＝-1．706，P〉0．05）。两组中无眼内出血及爆发性脉络膜上腔出血者。A组2只眼发生视网膜再脱离，B组为3只眼（z=-0．402，P〉0．05）。两组均无Objective To compare the safety and efficacy of silicone oil removal between the improved three-channel 25-gange （25G） incision and the three-channel. 23-gauge （23G） vitrectomy technique. Methods Patients who underwent silicone oil removal from January 2013 to December 2013 were included in this study. One hundred and twenty-nine patients were randomly divided into two groups： group A with improved three-channel 25-gauge incision and group B with three-channel 23G incision. Both groups were treated with three cannulas. In group A, 25G cannula was placed in inferiotemporally and upper left, 20G sclerotomies incision was made in the upper right. Standard 3-port 23-gauge cannula was performed in group B. Group A consisted of 63 patients （63 eyes）： 17 aphakia eyes, 9 pseudophakic eyes and 37 phakic eyes. Among the 63 eyes, twenty-three eyes were performed with silicone oil removal combined with phacoemulsification and intraocular lens implantation, nine eyes went on silicone oil removal and secondary intraocular lens implantation （five IOLs were sutured via ciliary sulcus）, eight eyes underwent silicone oil removal combined with membranes peeling and C3F8 tamponade, twenty-three eyes only underwent silicone oil removal. Duration of silicone oil tamponade was （4.7±3.3） months （Range： 3-13 months）. The preoperative visual acuity was from light perception to 0.2, the IOP from 7 to 38 mmHg, four eyes with silicone oil emulsification. Group B contained 66 patients （66 eyes）： 15aphakia eyes, 8 pseudophakic eyes and 43 phakic eyes. Among the 66 eyes, twenty-one eyes were performed with silicone oil removal combined with phacoemulsification and intraocular lens implantation, eight eyes went on silicone oil removal and secondary intraocular lens implantation （five IOLs were sutured via ciliary sulcus）, and thirty-seven eyes only underwent silicone oil removal. Duration of silicone oil tamponade was （5.3±3.5） months （Range： 3-14 months）. The preoperative visual acuity was fro

关 键 词：硅油取出术 25G 23G 三通道 临床观察 

分 类 号：R774.12[医药卫生—眼科]