玻璃体切除联合重硅油治疗下方视网膜脱离的临床研究

Clinical study of vitrectomy combined heavy silicone oil in the treatment of retinal detachment in the inferior quadrants

目的观察2种不同密度的硅油Densiron68与Oxane5700治疗下方视网膜脱离的临床效果。方法非随机前瞻性临床研究。玻璃体切除术联合硅油填充治疗视网膜脱离45例（46眼）。分析其临床疗效。结果随访至硅油取出术后6个月。Densiron68组和Oxane5700组在首次手术后视网膜复位率分别为78．3％和73．9％（P〉0．05）；进一步治疗后分别为91．3％和87．0％（P〉0．05）；随访结束时分别为91．3％和82．6％（P〉0．05）。但在曾行玻璃体手术或巩膜扣带术者的首次手术后复位率分别为71．4％和33，3％。术后炎症反应、硅油乳化、并发性或后发性白内障的发生率Densiron68组高于Oxane5700组（P〈0．05）。结论Densiron68和Oxane5700治疗复杂视网膜脱离的疗效无明显差异。术后炎症反应、硅油乳化、并发性或后发性白内障的发生率Densiron68组高于Oxane5700组。对曾使用普通硅油失败或无法坚持俯卧位者，Densiron68是一种较好的选择。

Objective To observe the clinical outcomes of two different density internal tampon- ades Densiron 68 and Oxane 5700 in the treatment of retinal detachment （RD） in the inferior quadrants. Methods This was a nonrandomized, perspective study. The study included 45 patients （46 eyes） with RD. Vitrectomy and silicone oil tamponade was performed in each case. Follow-up examinations were scheduled from iritial to 6 months after endotamponade removal. Results At the end of 6 month after surgery. The retinal reattachment rate of group Densiron 68 and group Oxane 5700 were 78.3% and 73.9% after ini- tial surgery （ P 〉 0.05 ） , with further interventions, which were 91.3 % and 87.0% （ P 〈 0.05 ） , 6 months after endotamponade removal the rate were 91.3 % and 82.6% （P 〈 0.05 ）. The retinal reattachment rate of patients, that had undergone scleral bulking or vitrectomy surgery, were 71.4% and 33.3% after vitrecto- my and silicone oil tamponade surgery. The rates of inflammation, emulsification, and complicated cataract or posterior capsular cataract in Densiron 68 group was more serious than Oxane 5700 group （P 〈 0.05 ）. Conclusions There is no difference of retinal reattachment in the treatment of retinal detachment in the inferior quadrants between Densiron 68 and Oxane 5700. The main complication was the higher rate of inflammation, emulsification, and complicated cataract or posterior capsular cataract in Densiron 68. Densiron 68 may be effective tool in the treatment of the cases of haveing been used conventional silicone oil or the patients cant keep prone position.