硅油填充眼发生视网膜脱离的原因及治疗效果

Causes and the efficacy of treatment of retinal detachment in silicone oil-filled eyes

目的分析硅油填充眼发生视网膜脱离的原因及治疗效果。方法回顾性分析2017年1月至2018年6月本院玻璃体切除术后硅油填充眼发生视网膜脱离70例(70只眼)的临床资料结果硅油眼发生视网膜脱离的原因有3类:视网膜下积液的产生者10只眼(14. 29%);原发裂孔闭合不佳或新裂孔形成者13只眼(18.57%);增生性玻璃体视网膜病变(PVR)进展者47只眼(67. 14%).所有患者经再次行视网膜修复术后视网膜均复位,再次术后的视力(BCVA)提高者60只眼(85.71%),不变化者9只眼(12.86%),下降者1只眼(1.43%)。术后平均视力(logMAR)优于术前,差异有统计学意义(t= 8.316,P = 0.000)(结论硅油眼发生视网膜脱离的主要原因是PVR进展,其次是原发裂孔闭合不佳或新裂孔形成,以及视网膜下积液产生。再次行视网膜复位手术可取得较好的治疗效果。

Objective To analyze the causes and the efficacy of retinal detachment in silicone oilfilled eyes. Methods The clinical data of 70 silicone oil-filled eyes of 70 cases of retinal detachment from Jan. 2017 to Jun. 2018 were collected and analyzed retrospectively. The causes of retinal detachment in silicone oil-filled eyes were observed. Results There were 3 kinds of causes of retinal detachment in silicone oil-filled eyes: subretinal effusion with retinal detachment in 10 eyes ( 14. 29%);poor closure of primary tear or formation of new tear in 13 eyes ( 18. 57%);the progress of proliferative vitreoretinopathy ( PVR) in 47 eyes ( 67. 14%). The retinas of all cases were reattached after retinal reconstructive surgery. Visual acuity after second surgery improved in 60 eyes ( 85. 71 %), unchanged in 9 eyes ( 12. 86%),decreased in 1 eye ( 1.43%). The average visual acuity after second surgery were better than that before surgery (t = 8. 316 ,P = 0. 000 ). Conclusion The retinal detachment in silicone oil-filled eyes is mainly caused by progress of PVR, followed by the poor closure of primary tear, the formation of new tear and the formation of subretinal effusion. Retinal reattachment surgery for the treatment of retinal detachment in silicone oil-filled eyes is effective.