Densiron68在玻璃体视网膜手术中应用的临床分析

High-density oil （Densiron68）as an intraocular tamponade in the vitrectomy

目的探讨Densiron68作为玻璃体腔填充物治疗玻璃体视网膜疾病的有效性及安全性。方法对18例19只眼玻璃体视网膜疾病患者人选，年龄在19～78岁，平均年龄（47．63±21．93）岁，术前术后常规行视力、眼压的测定，眼前后段检查、OCT、角膜内皮镜及B超等检查。手术方式包括：Densiron68填充术及硅油取出术。Densiron68的充填时间是44～141d，平均（76±23．84）d。取油后的随访时间为40～197d，平均（95．74~44．58）d。结果取油后，16只眼（84．21％）达到稳固的视网膜复位效果，1例患者（5．26％）在Densiron68充填第12d时出现了复发性视网膜脱离，2例（10．53％）取油后出现复发性视网膜脱离；术后视力较术前改善14只眼（73．68％）；术后OCT检测黄斑区各层形态结构基本正常，神经上皮层未见萎缩、变薄等现象；角膜内皮细胞计数术前、填充术后1月与取油术后1月比较无显著差异（P〉0．05）；术后并发症主要有短暂的前房反应、硅油乳化、晶体后囊膜混浊、术后一过性高眼压和瞳孔阻滞性青光眼。结论Densiron68作为玻璃体视网膜疾病的眼内填充物，可以明显提高患者视网膜的解剖复位率和视力，并对角膜内皮细胞和黄斑区神经上皮层无不良影响。虽然其填充后短期内并发症发生率较高，但不影响手术后的视网膜解剖复位率和视力提高。

Objective To evaluate the efficacy and security after using densiron 68 as an endotamponade in the vitrectomy.Methods Nineteen eyes of 18 patients aged 19 to 85 years old with vitreoretinopathy were included.Initial evaluation included present ophthalmologic and general medical history, determination of the best corrected visual acuity, intraocular pressure （IOP） measurement by non-contact tonometer, detailed slit lamp and fundus examination, OCT examination, corneal endothelinm examination.Surgery was performed as a standard three-port, pars plana vitrectomy.At removal surgery, 15 cases of the posterior poles discussion was performed.Mean duration of the Densiron68 endotamponade was 76± 23.84 days.Results After Densiron68 removal, 16 patients （84.21%） showed a stable reattached retinal without further interventions, while, in 1 patient （5.26%）, recurrent retinal redetachment appeared during endotamponade.Two patients （10.53%） developed redetachment after Densiron68 removal.Visual acuity was improved in 14 eyes （73.68%）. Postoperative measurement of the macular by optical coherence tomography was normal.The thickness of the neuroepithelial layer showed no apparent changes.The postoperative corneal endothelium cell showed no significant changes.Compared with the preoperatives, no statistically significant differences （P〉0.05）.Side effect included temporary inflammatory reaction, posterior capsular opacification, silicon oil emulsification, temporary intraocular pressure and pupillary block glaucoma.Conclusions The results showed that densiron68 as an endotamponade was efficacy and security.