硅油对眼屈光状态的影响及其相关因素分析

Analysis the effect of silicone oil tampomade on the refractive state and other related factors

目的:评估晶状体及囊膜状态对硅油填充眼屈光状态的影响,并探讨临床中与硅油填充眼屈光度改变有关的影响因素。方法:选择作硅油取出手术69只眼的病例资料。所填充硅油均为德国ACRITEC公司产品(粘度5000cps,屈光指数1.404);硅油填充玻璃体腔容积约4/5,眼底镜下新月形分界面清晰可见;硅油填充时间2-36个月,平均(7.49±6.01)个月。取油手术前1-3天,作检影验光;少数病例作B超检查了解眼内硅油泡形态、位置、与毗邻组织关系等情况。取油后4周复查时常规作视力、验光、眼压、眼底检查。前后两次检得的术眼屈光度差值作为取油后屈光度改变量。结果:69只眼分为三组:有晶状体组(n=34)、无晶状体囊膜完整组(n=22)及无晶状体无囊膜组(n=13)。各组取油后屈光度改变分别为-9.23±-2.82D、1.09±2.50D以及5.47±2.97D,各组数据之间比较存在统计学差异(均P<0.01)。各组内屈光度改变量个体差异均较大。在有晶状体组中,多元线性回归分析显示:年龄、性别、眼别、硅油填充时间、正常范围内眼压等因素均与屈光度改变无关,但与硅油填充前屈光度有关。结论:有晶状体眼、无晶状体囊膜完整眼及无囊膜眼中取油后屈光度改变均值各组内个体差异大。有晶状体时,手术前后的屈光度改变与年龄、性别、眼别、硅油填充时间、正常范围内眼压等因素无关,但与硅油填充前的术眼屈光度有关。理论推导参数或临床观察平均值在实际应用中都仅有参考意义。

Objective： To study the effect of len and capsMar state on the refractive state of silicone oil tamponade eyes, and invegitgate the factors infflunce on change of the refractive state. Results： We collected 69 cases with silicone oil removed. They were subvided into 3 groups, including phakic groups、 aphakic with capsular groups and aphakic without capsular groups. There was silicone oil occupying 4/5 of vitreous cavity . the duration Of silicone oil tamponade was 2 tO 36 monthes . mean （7.49 5： 6.01） monthes. All cases underwent retinoscopy optometry in 1 - 3 days before silicone oll removal operation Some eases underwent b - scan. In 4 weeks postoperation , visual acuity, optometry, IOP, fundus examination were performed. The differences of diopter between silicone oil filled eyes and silicone oil removed eyes were calculated.Results： The change of the refractive state between silicone oil filled eyes and silicone oil removed eyes was - 9.23 ± - 2.82D in phaldc group, 1.09 ± 250D in aphaldc with capsular group, 5.47 ± 2.97D in aphakic without capsular group. There is significant difference in groups with p〈 0.01. It vary with individual differences in group. In phakic group, rerationship between the change of the refractive state and age, sex、 eye、 the duration Of silicone oil tamponade were poor. With multiphe linear regression, but it is strong with the refractive state before silicone oil tamponade operation. Conclusion： The change of the refractive state between silicone oil filled eyes and silicone oil removed eyes vary with individual differences in group.The rerationship between the change of the refractive state and age, sex, eye、 the duration Of silicone oil tamponade were poor. With multlphe linear regression, but it is strong with the refractive state before silicone oil tamponade operation. This may be helpful in predicting the change of diopter of silicone oil tamponade eyes in practice.