视网膜脱离复位后硅油取出对硅油并发症的影响

THE EFFECTS OF SILICONE OIL REMOVAL ON THE COMPLICATIONS AFTER RETINAL DETACHMENT SURGERY

目的：探讨硅油取出对硅油并发症的影响。方法：回顾性分析法国国家眼科中心视网膜完全复位随访６个月以上的硅油取出病例９６例９６只眼，平均硅油充填期限６．４个月。结果：取硅油后视网膜脱离复发率为７．３％，硅油取出后晶体混浊仍继续发展，硅油充填３个月以上者无一眼保存透明晶体。取硅油前５只眼角膜病变，取后２只眼恢复透明；取硅油后新发病例４只眼，最终７只眼角膜病变者前房均可见残存的细小油滴。１５只眼取硅油前继发高眼压药物不能控制，取后１２只眼眼压控制；取硅油后新发病例１１只眼，其前房角均存在小油滴残留。结论：早期取出硅油可延缓但不能阻止白内障发生，早期和完全取出硅油可能阻止角膜病变和青光眼的发展。

PURPOSE:To assess the effects of silicone oil removal on the complications associated with its use.METHODS:Retrospective analysis of the results of silicone oil removal after vitreous surgery for retinal detachment in 96 eyes in National Ophthalmology Centre of French.The follow up period was at least six months and the mean duration of oil tamonade was 6.4 months. RESULTS:Retinal detachment recurred in 7.3%. The development of cataract continued after silicone oil removal.No patient retained a clear lens in the eye with oil remained in situ for more than 3 months.Two of 5 eyes with keratopathy at the time of oil removal recovered after the oil removal;but the corneas of another 4 eyes became dystrophic after the oil removal.Twelve of 15 eyes with secondary ocular hypertension incontrollable through medicinal treatment relieved after oil removal,but another 11 eyes became hypertensive after oil removal.Persistent emulsive droplets wre found in anterior chamber angles of the above 11 hypertensive eyes and the 7 eyes with keratopathy.CONCLUSINOS:Early removal of silicone oil after retinal detachment operation might delay the development of cataract but can not avoid its occurence,and ocular hypertension and keratopathy can be prevented by early and complete removal of silicone oil.