硅油取出联合玻璃体腔注射曲安奈德治疗硅油眼合并黄斑水肿的效果观察  

Observation on the efficacy of silicone oil removal combined with intravitreal injection of triamcinolone acetonide for the treatment of macular edema in eyes with silicone oil tamponade

作　　者：柯喜宣 李翠连 陈浩宇[1] Ke Xixuan;Li Cuilian;Chen Haoyu(Joint Shantou International Eye Center,Shantou University&the Chinese University of Hong Kong,Shantou 515041,China)

机构地区：[1]汕头大学·香港中文大学联合汕头国际眼科中心,汕头515041

出　　处：《中华眼外伤职业眼病杂志》2024年第1期59-62,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：汕头市科技项目(190716155262400)。

摘　　要：目的观察硅油取出联合玻璃体腔注射曲安奈德治疗硅油填充眼合并黄斑水肿的效果。方法回顾性病例系列研究。分析汕头大学·香港中文大学联合汕头国际眼科中心2016年1月至2021年11月20例(20眼)硅油眼合并黄斑水肿的临床资料, 所有患者视网膜均已复位3个月以上, 均采用常规三通道套管针取出硅油, 联合玻璃体腔注射曲安奈德混悬液2 mg。随访时间为3~48个月。分析手术后最佳矫正视力(BCVA, logMAR)及黄斑中心区厚度(CMT)的改变。结果本研究末次随访时BCVA为0.52(0.33, 0.89), 优于术前的1.00(0.81, 1.28)(Z=-3.73, P<0.001)。CMT从术前的456(371, 604)μm降到末次随访时的226(162, 396)μm(Z=-3.55, P<0.001)。4例(20%)出现暂时性高眼压, 以局部降眼压药物滴眼后眼压恢复正常。结论硅油取出联合玻璃体腔注射曲安奈德可有效改善硅油眼合并黄斑水肿患者的视力, 减轻黄斑水肿, 且无严重并发症。Objective To observe the efficacy of silicone oil removal combined with intravitreal injection of triamcinolone acetonide for the treatment of macular edema in eyes with silicone oil tamponade.Methods This was a retrospective case series study.The clinical data of 20 eyes of 20 cases of macular edema in silicone oil eyes from Jan.2016 to Nov.2021 in Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong were analyzed.The retinal detachment of each patient had been resolved for more than 3 months.Silicone oil was removed through pars plana trocar,and all cases received intravitreal injection of 2 mg triamcinolone acetonide suspension.Best corrected visual acuity(BCVA,logMAR)and central macular thickness(CMT)were analyzed after operation.The follow-up time was 3-48 months.Results BCVA improved from 1.00(0.81,1.28)before operation to 0.52(0.33,0.89)at the final visit(Z=-3.73,P<0.001).CMT reduced from 456(371,604)μm before operation to 226(162,396)μm at the final visit(Z=-3.55,P<0.001).Four patients(20%)occurred temporal high intraocular pressure(IOP),all of which were treated with topical IOP-lowering drugs.Conclusion Silicon oil removal combined with intravitreal triamcinolone acetonide injection can effectively improve visual acuity and alleviate macular edema without severe complications in silicone oil eyes with macular edema.

关 键 词：硅油眼 黄斑水肿 曲安奈德 黄斑中心区厚度 

分 类 号：R774.5[医药卫生—眼科]