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硅油取出后视网膜脱离发生率降低。

Reduced rate of retinal detachment following silicone oil removal.

作者信息

Bassat I B, Desatnik H, Alhalel A, Treister G, Moisseiev J

机构信息

The Goldschleger Eye Institute, The Sheba Medical Center, Tel Hashomer, Israel.

出版信息

Retina. 2000;20(6):597-603. doi: 10.1097/00006982-200011000-00002.

Abstract

PURPOSE

To investigate the rate of retinal redetachment and other complications after silicone oil removal over a 4-year period.

METHODS

Retrospective analysis of charts of patients who underwent vitrectomy and silicone oil injection between January 1994 and June 1998 followed by oil removal.

RESULTS

Sixty-eight eyes of 67 patients were included. The average follow-up time after oil removal was 15 months. Significant retinal redetachment developed in 6 eyes (8.8%). The redetachment rate was slightly higher in the 32 eyes with proliferative vitreoretinopathy (9.3%) than in the 36 eyes with other pathologies (8.3%). The average time to redetachment was 4.2 months. These eyes were reoperated and reattached, and at the end of the follow-up, three retained silicone oil. Two other eyes without redetachment were hypotonus after oil removal. Cataract extraction and intraocular lens implantation were performed at the time of oil removal in 18 eyes; 2 (11%) developed redetachment. Visual acuity improved significantly after oil removal (P < 0.001).

CONCLUSION

The rate of retinal redetachment after removal of silicone oil in recent years is low compared with previous series. The authors attribute this reduction to the improved surgical management of complicated retinal detachments; particularly, the introduction of perfluorocarbon liquids and wide-field viewing systems and the widespread use of endolaser.

摘要

目的

调查硅油取出术后4年期间视网膜再脱离及其他并发症的发生率。

方法

对1994年1月至1998年6月间接受玻璃体切除术和硅油注射并随后取出硅油的患者病历进行回顾性分析。

结果

纳入67例患者的68只眼。硅油取出后的平均随访时间为15个月。6只眼(8.8%)发生了明显的视网膜再脱离。增生性玻璃体视网膜病变的32只眼中再脱离率(9.3%)略高于其他病变的36只眼(8.3%)。再脱离的平均时间为4.2个月。这些眼再次手术并复位,随访结束时,3只眼保留了硅油。另外2只未发生再脱离的眼在硅油取出后眼压降低。18只眼在硅油取出时进行了白内障摘除和人工晶状体植入;2只眼(11%)发生了再脱离。硅油取出后视力显著改善(P<0.001)。

结论

与以往系列研究相比,近年来硅油取出术后视网膜再脱离的发生率较低。作者将这种降低归因于复杂视网膜脱离手术管理的改善;特别是全氟碳液体和广角观察系统的引入以及眼内激光的广泛应用。

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