经角膜隧道切口的无晶状体眼硅油取出术

Silicone oil removal by corneal tunnel incision from aphakia

目的 应用经角膜隧道切口的改良手术方法取出晶状体玻璃体切割 (PPV +PPL)术后填充的眼内硅油 ,考察并评价其临床效果。方法 对 1 8例曾行PPV +PPL的无晶状体硅油填充眼行经角膜隧道切口的硅油取出术。局麻下 ,将灌注管固定于术眼颞下方平坦部处灌注 ,用剪短至5mm左右长的 2 0G静脉穿刺套管经透明角膜隧道穿刺口负压抽取硅油 ,并在显微镜下仔细置换出残留的小油滴。结果 1 8例眼内硅油均一次成功取出 (成功率 1 0 0 % )。主要并发症有 :1 4眼术后低眼压 ( 77. 8% ) ;7眼玻璃体混浊 ( 38. 9% ) ;1眼视网膜脱离复发 ( 5 6 % )。结论 经角膜隧道切口取出无晶状体眼内硅油的改良手术 ,方法简单有效而且并发症少 ,具有较广泛的临床应用价值。

Objective To observe and assess the clinical outcome and effect of a modified method to remove silicone oil through a corneal tunnel incision from aphakic eyes after previous lensectomy and vitrectomy.Methods 18 eyes had received this simplified surgery to remove the silicone oil after lensectomy-vitrectomy as well as silicone oil tamponade.With local anesthesia,we used an irrigation duct to infuse inferiorly,and a 20G venipuncture cannula(shortened to 5mm or so)through a corneal tunnel incision to extract the silicone oil from aphakia.At the end,remained oil drops were eliminated under microscopy.Results All 18 eyes(100%)obtained primary success in extracting of silicone oil.Complications occur in 14 cases(77 8%)of transient post-operation low intraocular pressure,7 eyes(38 9%)with temporary vitreous opacity and 1(5 6%)with recurrent retinal detachment.Conclusions The modified procedures using transparent corneal tunnel incision in extraction of silicone oil from aphakia is a simple and effective method with less complications,and thus has comprhensive application value in clinic.