玻璃体腔重硅油填充治疗硅油填充眼复发性视网膜脱离的临床研究

Clinical research of intravitreal heavy silicone oil tamponade for the treatment of recurrent retinal detachment of silicone oil-filled eyes

目的 探讨应用重硅油填充治疗硅油填充眼复发性视网膜脱离的价值.方法 对硅油填充眼复发性视网膜脱离12例12眼进行玻璃体切割联合重硅油填充术治疗,术中根据病情联合视网膜切开、剥膜、视网膜光凝、视网膜电凝、重水应用、气液交换、白内障超声乳化吸出等处理,对手术疗效、术后并发症等进行随访和评价.结果 术后随访6～24个月,8例（占66.7％）在重硅油取出后视网膜完全复位,术后视力5只眼提高,6只眼不变,1只眼下降,3只眼发生硅油乳化（占25.0％）,眼压升高2只眼（占16.7％）,前房炎症反应2只眼（占16.7％）,2只有晶状体眼中1只发生白内障（占50.0％）.结论 重硅油填充治疗硅油眼复发性视网膜脱离是安全有效的。

Objective To evaluate the value of heavy silicone oil tamponade for recurrent retinal de- tachment of silicone oil-filled eyes. Methods Vitreetomy combined with intraocular heavy silicone oil tam- ponade was performed in 12 patients （12 eyes） with recurrent retinal detachment of silicone oil-filled eyes. Depending on intraoperative situation, patients accepted extra operations like retinotomy, membrane peeling, retinal photocoagulation, retinal electrocoagulation, heavy water application, air-fluid exchange or phacoemul- sification. The surgical efficacy and post-surgical complications were followed up and assessed. Results The followed-up period was 6 to 24 months. During the follow-up, Reattachment of retina was found in 8 cases （66.7%）. The visual acuity after the operation was improved in 5 cases, sustained in 6 cases, declined in one case. There were 3 cases with silicon oil emulsification （25.0%） , 2 cases with increased intraocular pressure （ 16.7% ）, and 2 cases with anterior chamber inflammation （ 16.7% ）. Cataract was found in one of two eyes with normal lens （50.0%）. Conclusions Heavy silicone oil tamponade is effective for recurrent retinal detachment in silicone oil-filled eyes.