二次硅油注入术治疗复发性视网膜脱离

Secondary silicone oil injection for recurrent retinal detachment in silicone oil tamponaded eyes

目的 :分析带硅油眼复发性视网膜脱离的原因 ,总结二次硅油注入术治疗带硅油眼复发、复杂性视网膜脱离的效果。方法 :对 15 0例带硅油眼的复发性视网膜脱离 ,其中 40例复杂性视网膜脱离接受二次硅油注入术进行了回顾性分析。结果 :带硅油眼的视网膜脱离以下方为主 ,其主要原因为硅油上浮 ,原裂孔封闭不好或裂开 ,新裂孔形成 ,增殖性玻璃体视网膜病变(PVR)的牵引。对 40例带硅油眼的视网膜脱离进行了硅油再次注入术 ,平均随访 8个月。视网膜解剖复位 34例 (85 % )。二次硅油取出术 12例 ,视网膜解剖复位 9例 (75 % )。结论 :带硅油眼的复发性视网膜脱离的主要原因是玻璃体牵引 ,对于复杂性病例 ,行硅油再次注入术成功率较高。

To analyze the factors of recurrent retinal detachment in silicone oil tamponaded eyes and summarize the effects of secondary silicone oil injection for the recurrent retinal detachment in silicone oil tamponaded eyes. Methods: 150 cases of. recurrent retinal detachment in silicone oil tamponaded eyes were reviewed retrospectively, among them, 4o severe cases (40 eyes) underwent silicone oil removal and secondary silicone oil exchange. Results: Because of flotation force property of silicone oil, the recurrent retinal detachments in silicone oil tamponaded eyes were found inferiorly in most of the cases. The main causes included reopening due to the inadequate seal of primary retinal beaks, new retinal breaks formation and proliferative vitreous retinopathy. 40 eyes with secondary silicone oil injection were followed up for 1 to 14 months (8 months in average), in totally 34 eyes (85%) achieved anatomical retinal reattachment. Of the 40 eyes, 12 eyes were secondly underwent silicone oil removal surgery and retina remained attached in 9 eyes (75%). Conclusions: The results suggested that various factors affected the-re-detachment of retina in the eye with silicone oil tamponaded. In most complicated cases, it might be necessary to re-inject the silicone oil.