重硅油填充治疗老年视网膜脱离病人的疗效观察

Effects of heavy silicone oil tamponade in the treatment of senile retinal detachment

目的观察重硅油填充治疗老年视网膜脱离病人的临床效果。方法选择2011年1月至2016年1月我院收治的老年复杂视网膜脱离病人76例,随机分为治疗组38例与对照组38例,均采用玻璃体切除术,治疗组给予重硅油(Densiron-68)填充,对照组给予普通硅油FCI(S5.7570)填充。观察术后视网膜复位、视力、眼压及并发症情况。结果术后1周2组视网膜复位率均为100%。治疗组重硅油取出术前及术后发现视网膜脱离4例,对照组普通硅油取出术前及术后发现视网膜脱离7例,2组比较差异无统计学意义(P>0.05)。2组均随访3~18个月,治疗组术后视力较术前提高者24例,对照组术后视力较术前提高者20例。2组术后均未发现难以控制的高眼压,治疗组重硅油乳化率为100.00%,对照组硅油乳化率为21.05%,差异有统计学意义(P>0.05)。治疗组均无眼外不可耐受的不适,对照组均出现因头低俯卧位造成的面部水肿、肩颈疼痛、手肘皮肤破损、腰酸腿麻、失眠等不适。结论应用重硅油眼内填充治疗复杂视网膜脱离,对不能长期保持头低俯卧位的老年病人效果较好,并发症少,病人依从性好,容易耐受。

Objective To observe the clinical effect of heavy silicone oil tamponade in the treatment of retinal detachment in the elderly patients. Methods Totally 76 cases of eldely patients with retinal detachment were divided into two groups,with 38 patients in each group. The treatment group was treated by heavy silicone oil（ Densiron-68） tamponade and control group was treated by normal silicone oil FCI（ S5. 7570） tamponade. All the patients were treated with vitrectomy. The retinal reattachment,visual acuity,intraocular pressure and complications were observed after treatment.Results One week after operation,the retinal reattachment rate of two groups was 100%. There were 4 cases of retinal detachment before and after heavy silicone oil removed in the treatment group,compared with 7 cases in the control group（ P0. 05）. After a follow-up of 3-18 months,postoperative visual acuity was improved in 24 cases in the treatment group and in 20 cases in the control group（ P0. 05）. No case of high uncontrollable intraocular pressure was found after surgery. The heavy silicone oil emulsification rate was 100% in treatment group,compared 21% in control group（ P 0. 05）. All the patients in the treatment group did not show discomfort. All patients in the control group expressed discomfort due to facial edema,shoulder neck pain,elbow skin damage,lumbago leg flax,insomnia. Conclusions Application of heavy silicone oil tamponade can maintain long-term good effect on elderly patients in prone position with fewer complications and good compliance.