眼内窥镜引导简化硅油取出的方法  

Simplifying silicone oil removal guided by ophthalmic endoscope

作　　者：俞永珍 张楚 周文杰 陈京霞 邹秀兰 彭亮红 张春丽 章梦一 程天豪 余洋洋 邹玉平 YU Yong-zhen;ZHANG Chu;ZHOU Wen-jie;CHEN Jing-xia;ZOU Xiu-lan;PENG Liang-hong;ZHANG Chun-li;ZHANG Meng-yi;CHENG Tian-hao;YU Yang-yang;ZOU Yu-ping(Department of Ophthalmology,General Hospital of Southern Theatre Command,Guangzhou,510010,Guangdong,China;不详)

机构地区：[1]中国人民解放军南部战区总医院眼科,广东广州510010

出　　处：《广东医学》2023年第1期102-106,共5页Guangdong Medical Journal

基　　金：广东省自然科学基金项目(2019A1515011732);广州市科技计划项目(202002030413)。

摘　　要：目的利用眼内窥镜的优点,探讨简化玻璃体腔硅油取出的方法。方法回顾82例(97眼)内窥镜引导下的无晶状体眼或联合白内障摘除术的硅油取出术的病例,记录其手术时间和术中并发症,随访27~60个月,观察其术后1 d、1周、1个月、6个月的视力、眼压、角膜内皮细胞密度、视网膜脱离复发率、硅油残留率和其他并发症。结果手术时间15.6~46.3 min,平均(20.6±8.3)min,术中未见明显并发症。术前最佳矫正视力(best corrected visual acuity,BCVA)为(2.04±0.58)LogMAR,术后1 d、1周、1个月、6个月的BCVA为(1.92±0.79)LogMAR、(0.94±0.57)LogMAR、(0.98±0.61)LogMAR、(0.96±0.69)LogMAR,术后1 d视力与术前比较,差异无统计学意义(P>0.05),但术后1周、1个月、6个月与术前视力比较,差异有统计学意义(P<0.05);术前眼压为(17.65±1.33)mmHg,术后1 d、1周、1个月、6个月眼压为(9.21±3.81)mmHg、(13.57±2.93)mmHg、(14.75±3.60)mmHg、(15.15±2.32)mmHg,术后1 d与术前眼压比较,差异有统计学意义(P<0.05),术后1周、1个月、6个月与术前眼压比较,差异无统计学意义(P>0.05);比较不同年龄亚组的术前、术后的角膜内皮细胞密度可知,各年龄组的角膜内皮细胞密度术后1 d与术前比较,差异有统计学意义(P<0.05),术后1周、1个月、6个月角膜内皮细胞密度与术后1 d比较所有升高,与术前角膜内皮细胞密度比较,差异无统计学意义(P>0.05)。术后视网膜脱离复发1例(1眼,1.03%),无硅油残留和持续性角膜水肿病例。结论眼内窥镜引导下的简化硅油取出法,简化了硅油取出的操作,减少了手术创伤,减少了术后硅油残留,并且不增加术中术后并发症,是一种安全有效的新方法。Objective To evaluatea simplified method of silicone oil removal using endoscope′s advantages.Methods Eighty-two cases(97 eyes)of endoscope-guided silicone oil removal from aphakic eyes or combined with cataract extraction were reviewed.Follow-up time was 27 to 60 months.Surgical time,pre-operative and 1 day,1 week,1 month and 6 month spostoperative visual acuity,intraocular pressure(IOP),corneal endothelial cell density as well as intra-and postoperative complications were recorded.Results Surgical time was 20.6 minutes(15.6-46.3 minutes).The best corrected visual acuity(BCVA)before operation was(2.04±0.58)LogMAR;and they were(1.92±0.79)LogMAR,(0.94±0.57)LogMAR,(0.98±0.61)LogMAR and(0.96±0.69)LogMAR 1 day,1 week,1 month and 6 months after operation,respectively.There was no significant difference in BCVA between before and 1 day after operation(P>0.05);and there were statistical significant differences in BCVA among 1 week,1 month and 6 months post-operation compared to pre-operation(P<0.05).The IOP was(17.65±1.33)mmHg before operation,and they were(9.21±3.81)mmHg,(13.57±2.93)mmHg,(14.75±3.60)mmHg and(15.15±2.32)mmHg 1 day,1 week,1 month and 6 months after operation,respectively.There was significant difference in IOP between before and 1 day after operation(P<0.05),while there was no statistical significant difference among 1 week,1 month and 6 months post-operation compared to pre-operation(P>0.05).Compared with before operation,the corneal endothelial cell density was significantly increased 1 day,1 week,1 month and 6 months after operation among different sub-groups according to ages.There was significant difference in corneal endothelial cell density between pre-operation and 1 day post-operation(P<0.05),while there was no statistical significant difference among 1 week,1 month or 6 months post-operation compared to pre-operation(P>0.05).Retinal detachment relapsed in 1 eye(1.03%).No silicone oil remnant or persistent corneal edema was found.Conclusion The endoscopy-guided simplified technique o

关 键 词：内窥镜 硅油取出 视网膜脱离 眼压 

分 类 号：R779.6[医药卫生—眼科] R776.1[医药卫生—临床医学]