经瞳孔区与经睫状体平坦部硅油取出术的临床疗效比较

Comparison of clinical effects between silicone oil removal through pupil and ciliary pars plana

目的比较经瞳孔区与经睫状体平坦部硅油取出术的临床效果。方法回顾性分析孔源性视网膜脱离患者术后行硅油取出联合人工晶状体植入术共45例(45只眼),经瞳孔区取出硅油者24例,经睫状体平坦部者21例。记录并分析手术时间、术后1个月最佳矫正视力、眼B型超声及相关并发症情况。结果经瞳孔区取硅油者手术时间为(17.63±2.55)min,经睫状体平坦部取硅油者为(30.24±4.11)min,差异具有统计学意义(P<0.05)。术后1个月复查B型超声,前者1例硅油残留,后者5例残留,差异具有统计学意义(P<0.05)。两组术后1个月最佳矫正视力、脉络膜脱离、视网膜脱离、玻璃体混浊、玻璃体积血的发生率比较,差异均无统计学意义。结论经瞳孔区硅油取出术较经睫状体平坦部具有手术时间短、术后硅油残留几率低、手术安全性高等优势,在临床中具有一定的应用价值。

Objective To compare the clinical effects of silicone oil removal through pupil surgery and through ciliary pars plana. Methods Retrospective analysis was performed based on fourty-five patients with rhegmatogenous retinal detachment who postoperatively underwent silicone oil removal combined with intraocular lenses (IOL) implantation. Among the enrolled patients,24 underwent silicone oil removal trough pupil, while 21 underwent silicone oil removal trough ciliary pars plana.The surgery duration,as well as the best corrected visual acuity (BCVA),B ultrasonic examination and surgical complications at 1-month postoperatively were recorded.Results The mean duration of silicone oil removal through pupil was 17.63±2.55 min while that through ciliary pars plana was 30.24±4.11 min. The difference was statistically significant between two groups ( P <0.05). The 1-month postoperative B ultrasound showed that 1 patient and 5 patients had silicon oil retention in the pupil group and the ciliary pars plana group,respectively,and the difference was statistically significant ( P <0.05).There were no significant differences in BCVA,as well as the incidences of choroidal detachment, recurrent retinal detachment,vitreous opacity and vitreous hemorrhage at 1-month after the surgery between the two groups.Conclusions In comparison with silicone oil removal through ciliary pars plana,silicone oil removal through pupil is more time-saving and safer with lower incidence of silicon oil retention after the surgery, thus has implications in clinical application.