玻璃体切割注硅油术治疗复杂性视网膜脱离的远期疗效和并发症

The long-term theraputic effects and complications of silicone oil tamponade after vitrectomy in complicated retinal detachment

目的探讨玻璃体切割注硅油术治疗复杂性视网膜脱离的远期疗效和并发症，并对如何改进硅油应用方法进行讨论。方法回顾性分析了５０例硅油注入病例。结果手术后视网膜复位率为９４％，随访１２～４１个月，复位率降为７０％，并发症总发生率９０％，其中白内障发生率为７８％（有晶体眼白内障为９７．５％），硅油进入前房、继发性青光眼、角膜病变各为２４％，１０例行硅油取出，其中５例视网膜再脱离，另有２例先发生前房出血后视网膜脱离。结论硅油长期在眼内导致严重并发症，硅油取出后又有视网膜再脱离及其它新并发症的危险，临床上应用硅油要严格掌握适应症和方法。

Objective The study was designed to elucidate the long-term theraputic effects and complications of silicone oil tamponade after vitrectomy in complicated retinal detachment.The better application of the substance was also discussed.Method Retrospective analysis of the consequences of silicone oil tamponade in 50 eyes.Results The rates of retinal reattachment were 94% and 70% immediately and 12 to 41 months after the operation separately.The sum of the incidences of complications was 90%,the incidence of cataract was 78%(97.5% in phakic eyes);silicone oil moving into anterior chamber,24%;secondary glaucoma,24%;keratopathy,24%.Retinal redetachment occurs in 5 out of 10 cases undergoing silicone oil removal,Anterior chamber hemorrhage followed by retinal redetachment occurs in 2 other cases.Conclusions The protracted retaining of silicone oil will cause serious complications,but its removal can cause retinal redetachment and other new complications.Strictly controlling the indications and improving the usage of silicone oil are necessary.