硅油填充下牵引性视网膜脱离的手术治疗

A study of vitrectomy for retina traction redetachment in eyes with silicon oil retained

目的总结硅油填充眼牵引性视网膜脱离在硅油下视网膜复位手术的疗效,探讨该手术的手术技巧及并发症的处理。方法观察19例(19只眼)硅油填充术后发生牵引性视网膜脱离患者,在保留硅油的条件下,做常规睫状体平坦部巩膜三切口,原灌注口接硅油灌注管,在导光纤维的导引下行膜剥离、视网膜增殖疤痕切开松解、内排液、补充硅油、眼内光凝等手术使视网膜复位的手术治疗。结果19只眼中,术后视网膜基本复位,术后发生一过性高眼压14例,前房、玻璃体出血2例,视网膜创伤疤痕增殖病灶过大,周边局部牵引性脱离复发2例。结论有硅油眼牵引性视网膜脱离在硅油填充下的膜剥离松解手术,具有方法简便、节省时间、剥膜止血容易等优点,是严重增殖性复发性视网膜脱离手术最终获得成功的关键过程。

Objective To evaluate the outcome of the vitrectomy for retina traction redetachment in eyes with silicon oil tamponade and investigate the complications and the surgical techniques for this surgery. Methods A trial of 19 eyes(19 cases),in which retina traction redetachment developed after the management of silicon oil tamponade,under went pars plana vitrectomy with silicon oil retained and the indwelling gravity-fed infusion terminal was replaced by the oil tamponade terminal.Directed by endoilluminator,membrane peeling and relaxing,removal of subretinal liquids and injection of additional oil,etc.were performed to make retina reattachment. Results After operation,all eyes achieved retinal reattachment.There were 14 eyes with temporal ocular hypertension,2 eyes with anterior chamber and vitreous hemorrhage,2 eyes with retina traction redetachment. Conclusions The advantages of vitrectomy with silicone oil retained are simple operation,time-saving,easiness of membrane-peeling and hemostasis,etc.But this operation should be well trained,mastered and doing.