增生膜剥除术联合激光光凝治疗硅油填充眼增生性玻璃体视网膜病变的效果

The efficacy of proliferative membrane stripping combined with retinal laser photocoagulation for the treatment of proliferative vitreoretinopathy on silicone oil-filled eyes

目的评价增生膜剥除术联合视网膜激光光凝治疗硅油填充眼增生性玻璃体视网膜病变（PVR）的效果。方法回顾性研究，对象是2013年1月至2015年6月本院眼一科第二治疗组玻璃体切除联合硅油填充术后发生PVR，进行增生膜剥除术联合视网膜激光光凝治疗者66例（66只眼）。统计分析其手术前后视力、黄斑中心区厚度、视网膜复位情况、硅油取出时间以及术后并发症情况。结果全组66只眼术后视网膜均复位，而且未出现严重并发症。术后3个月内取出硅油者39只眼（59．09％），4—6个月内取出硅油者27只眼（40．91％）。行2～4次剥膜手术10只眼（15．15％），取出硅油后发生复发性视网膜脱离2只眼（3．03％），再次行硅油填充术至视网膜复位。术后视力较术前显著提高，差异具有统计学意义（X^2=14．85，P=0．0019）。手术前黄斑中心区厚度平均为（352．70±55．52）um，手术后3个月减少至（324．37±49．74）μm，差异有统计学意义（￡=7．591，P=0．000）。结论增生膜剥除术联合视网膜激光光凝治疗硅油填充眼发生PVR者效果确切。

Objective To evaluate the efficacy of proliferative membrane stripping combined with retinal laser photocoagulation for the treatment of proliferative vitreoretinopathy （ PVR ） on silicone oil-filled eyes. Methods The data of 66 eyes of 66 patients with PVR after vitrectomy combined with silicone oil tamponade surgery from January 2013 to June 2015 in our hospital were retrospectively analyzed. These patients received proliferative membrane stripping combined with retinal laser photocoagulation. The visual acuity before and after the surgery, central macular thickness, retinal reattachment, the timing of silicone oil removal and postoperative complications were observed and analyzed. Results The retinas were reattached in all 66 eyes after the surgery and no serious complication occurred. The removal of the silicone oil was within 3 months in 39 eyes （ 59.09% ） and 4 to 6 months in 27 eyes （40.91%）. The membrane stripping operation was performed 2 to 4 times in 10 eyes （ 15. 15% ）. The recur：rent retinal detachment occurred after the oil removal in 2 eyes （3.03%） and the silicone oil tamponade surgery was performed again to reattach the retina. The postoperative visual acuity improved significantly compared with preoperative visual acuity and the difference was statistically significant （ X^2 = 14.85, P = 0. 0019 ）. Before the surgery the mean thickness of central macular area was （ 352.70 ±55.52）μm. Three months after the surgery the thickness reduc, ed to （324.37±49.74）μm and the difference was statistically significant （t =7. 591, P = 0,000 ）. Conclusion Proliferative membrane stripping combined with retinal laser photocoagulation for PVR on silicone oil-filled eyes is exactly effective.