硅油取出前视网膜脱离病因分析

Recurrent retinal detachment before silicone oil removal

目的报告硅油取出前视网膜脱离发生率，并分析发生此视网膜脱离的有关病因。方法选择增生性玻璃体视网膜病变（ＰＶＲ）和增生型糖尿病视网膜病变患者行玻璃体切割联合硅油填充手术。结果１６眼中，有１０眼在硅油取出前视网膜复位，６眼视网膜脱离，视网膜脱离发生率为３７．５％。视力增进４眼（２５％），不变８眼（５０％），下降４眼（２５％）。术后并发症为晶状体混浊加重（５眼，３１％），继发性青光眼（２眼，１３％），虹膜新生血管（１眼，６％），低眼压（２眼，１３％），ＰＶＲ加重（２眼，１３％）。结论硅油取出前视网膜脱离发生主要原因为原裂孔未封闭，新裂孔形成，视网膜表面增殖膜形成等。

ObjectiveTo report the incidence of retinal detachment before silicone oil removal and analyze the relative risks.MethodsA retrospective analysis of 16 consecutive patients(16 eyes)with proliferative vitreoretinopathy(PVR)or proliferative diabetic retinopathy(PDR) who underwent pars plana vitrectomy and silicone oil tamponate was conducted.The mean duration from silicone oil injection to the occurrence of retinal detachment was 5 months(range,3-6 months).ResultsTen(62.5%)of 16 eyes had retinal attachment.Six eyes(37.5%)had retinal detachment.Visual acuities increased in 4 eyes(25%),stabilized in 8 eyes(50%),and deteriorated in 4 eyes(25%).Postoperative complications included nucleus sclerosis cataract in 5 eyes(21%),secondary glaucoma in 2 eyes(13%),rubeosis iridis in 1 eye(6%),low intraocular pressure in 2 eyes (13%) and increased PVR in 2 eyes (13%).ConclusionOriginal retinal hole unclosure,new retinal hole formation,and epiretinal proliferation are thought to be the probable causes of those retinal detachment.