眼内硅油填充取出术后视网膜再脱离
Retinal redetachment after removal of intraocular silicone oil tamponade.
作者信息
Jonas J B, Knorr H L, Rank R M, Budde W M
机构信息
Department of Ophthalmology and Eye Hospital, University Erlangen-Nürnberg, Germany.
出版信息
Br J Ophthalmol. 2001 Oct;85(10):1203-7. doi: 10.1136/bjo.85.10.1203.
AIM
To evaluate frequency and risk factors of retinal redetachment after removal of intraocular silicone oil tamponade.
METHODS
The study included 225 patients who consecutively underwent intraocular silicone oil removal at a mean interval of 10 months after pars plana vitrectomy had been performed by one of two surgeons. Mean follow up time was 17.37 (SD 14.40) months (range 3.02-67.42 months).
RESULTS
In 57 of 225 (25.3%) patients, the retina detached after removal of silicone oil. Risk factors for retinal redetachment were the following: number of previously unsuccessful retinal detachment surgeries (p=0.0008); surgeon (p=0.007); visual acuity before silicone oil removal (p=0.009); incomplete removal of vitreous base (p=0.01); absence of an encircling band in eyes with proliferate vitreoretinopathy in which an inferior retinotomy had not been performed (p=0.01); and indication for pars plana vitrectomy. Rate of retinal redetachment was statistically (p>0.05) independent of the technique of silicone oil removal and duration of silicone oil endotamponade.
CONCLUSION
Retinal redetachment after removal of silicone oil endotamponade can occur in approximately a fourth of patients, depending on the criteria to use and to remove silicone oil. Risk factors for recurrent detachment included the following: number of previously unsuccessful retinal detachment surgeries, surgeon, preoperative visual acuity, incomplete removal of the vitreous base, absence of an encircling band, and reason for pars plana vitrectomy. The rate of retinal redetachment is independent of the technique of silicone oil removal and duration of silicone oil endotamponade, with a minimal duration of silicone oil tamponade of about 3 months in the present study.
目的
评估眼内硅油填充取出术后视网膜再脱离的发生率及危险因素。
方法
本研究纳入了225例患者，他们由两位外科医生之一连续进行了眼内硅油取出术，平均间隔时间为玻璃体切除术后10个月。平均随访时间为17.37（标准差14.40）个月（范围3.02 - 67.42个月）。
结果
225例患者中有57例（25.3%）在硅油取出后视网膜发生脱离。视网膜再脱离的危险因素如下：既往视网膜脱离手术失败次数（p = 0.0008）；外科医生（p = 0.007）；硅油取出术前的视力（p = 0.009）；玻璃体基底部切除不完全（p = 0.01）；增生性玻璃体视网膜病变且未行下方视网膜切开术的眼中未使用环扎带（p = 0.01）；以及玻璃体切除的指征。视网膜再脱离的发生率在统计学上（p>0.05）与硅油取出技术及硅油眼内填充时间无关。
结论
根据硅油使用及取出标准，约四分之一的患者在取出硅油眼内填充后会发生视网膜再脱离。复发性脱离的危险因素包括：既往视网膜脱离手术失败次数、外科医生、术前视力、玻璃体基底部切除不完全、未使用环扎带以及玻璃体切除的原因。视网膜再脱离的发生率与硅油取出技术及硅油眼内填充时间无关，在本研究中硅油眼内填充的最短时间约为3个月。
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