硅油取出联合外路显微手术治疗硅油填充眼视网膜脱离

Silicon oil removed combined with external-route microsurgery for retinal detachment in silicon oil tamponaded eyes

目的:探讨同期行硅油取出联合外路显微手术治疗硅油填充眼视网膜脱离的适应证及临床效果。方法:回顾性系列病例研究。收集2014-07/2018-07间在我院眼科同期行硅油取出联合外路显微手术治疗的硅油填充眼视网膜脱离患者21例21眼的临床资料。分析视网膜脱离的原因、视网膜复位的效果、视力改善情况以及手术并发症等。结果:所有病例手术后随访4~12(平均5.48±1.53)mo;一次手术视网膜解剖复位19眼,手术成功率90%,其它2眼需再次行内路玻璃体切除联合硅油填充术;术后最佳矫正视力(BCVA)≥0.4者4眼,0.06~0.3者9眼,≤0.05者8眼,术后LogMAR视力(1.10±0.58)与术前(1.66±0.74)相比有差异(t=3.58,P<0.05)。术后发生黄斑前膜1眼,继发青光眼2眼,并发性白内障5眼,未见其他严重并发症发生。结论:对于增殖性玻璃体视网膜病变(PVR)≤C1、裂孔位于赤道及以前的硅油填充眼视网膜脱离可采用同期硅油取出联合外路显微手术治疗,具有操作方便、视网膜复位率高、并发症少等优点,同时可减少再次玻璃体切除术或硅油填充的机会。

·AIM:To evaluate the efficacy of silicon oil removal combined with external-route microsurgery in treating of retinal detachment in selected eyes with silicone oil tamponaded.·METHODS:This was a retrospective observational case series.21 cases(21 eyes)had undergone minimally invasive vitrectomy combined with silicone oil tamponade for various vitreoretinal diseases firstly.Because of retinal detachment recurrent,external-route microsurgery combined with oil extracted was performed between July 2014 and July 2018 secondly.The retinal reattachment rate,visual outcome,intraocular pressure and postoperative complications were investigated.·RESULTS:After 4 to 12(5.48±1.53)mo follow-up period,the retinal reattachment rate was 90%(19/21 cases).Further vitrectomy surgeries were needed for other 2 eyes.The final best corrected visual acuity(BCVA)≥0.4 was in 4 eyes,0.06-0.3 was in 9 eyes and≤0.05 was in 8 eyes,which had significant difference contrasted to that of preoperation(t=3.58,P<0.05).Macular epiretinal membrane,second glaucoma and complicated cataracts were found in 1,2 and 5 eyes respectively.There hadn't other serious complications postoperatively.·CONCLUSION:The external-route microsurgery was also suitable for retinal detachment in silicone oil filled eyes which were PVR≤C1 and the roles located in the equator region or front even.This way was simple,convenient and effective.The rate of secondary vitrectomy with silicone oil tamponade also can be reduced.