23G 微创睫状体平坦部巩膜切口硅油取出的临床观察

Clinical study of silicone oil removal via 23-gauge pars plana incision

目的：观察23G 微创睫状体平坦部巩膜切口硅油取出的有效性和安全性。方法选取2015年3月到2016年03月在我院眼科住院的23例（23眼）玻璃体切除术后硅油眼患者，行23G 微创睫状体平坦部巩膜切口硅油取出，观察术后1wk 、1mo 、3mo 最佳矫正视力、眼压、眼前节炎症、并发症等情况。结果术后1wk 视力提高11眼，视力稳定9眼，视力降低3眼，眼压9．1±3．7mmhg ，未见视网膜脱离、脉络膜脱离等并发症。术后1mo 随访时视力提高13眼，视力稳定8眼，视力降低2眼，眼压15．1±4．3mmhg 。术后3mo 随访时视力提高14眼，视力稳定7眼，视力降低2眼，眼压13．9±3．8mmhg ，1眼发生视网膜脱离，2眼发生脉络膜脱离。结论23G 微创睫状体平坦部巩膜切口硅油取出手术具有手术损伤小、手术步骤少、舒适度高、术后并发症少等优点，是一种安全有效的手术方式，值得临床推广。

Objective To evaluate the efficacy and safety of silicone oil removal via 23‐gauge（23G） pars plana incision .Methods From March 2015 to March 2016 ,23 patients （23 eyes ） with silicone oil intraocular tamponade after vitrectomy were treated in the department of ophthalmology in our hospital .All patients underwent silicone oil removal via 23G pars plana incision ,the best corrected visual acuity （BCVA） , intraocular pressure（IOP） ,anterior segment inflammation and postoperative complications were observed in 1wk ,1mo and 3mo after surgery .Results At postoperative 1 week ,1month ,3 months ,BCVA was improved obviously in 11 eyes ,13 eyes ,14 eyes ,respectively ,and was stabled in 9 eyes ,8 eyes ,7 eyes ,respectively ,and was decreased in 3 eyes ,2 eye ,2eyes ,respectively .The average IOP after surgery was 9 .1 ± 3 .7 mm Hg ,15 . 1 ± 4 .3 mm Hg ,and 13 .9 ± 3 .8 mm Hg after one week ,one month and three months ,respectively .There was no occurrence of retinal detachment ,choroidal detachment or other severe postoperative complications during 1wk or 1 mo after surgery .Only 1 case occurred retinal detachment ,and 2 cases occurred choroidal detachment 3mo after operation .Conclusion This silicone oil removal surgery via 23G pars plana incision is safe ,effective and deserves to broadcast ,which has advantages in terms of small injury ,easy operation ,high comfort and less complication .