Nawrocki Jerzy, Starska Dorota
Katedra i Klinika Chorób Oczu Akademii Medycznej w Łodzi.
Klin Oczna. 2002;104(1):30-2.
Retinal redetachment after primarily successful vitreous surgery with silicone oil tamponade is quite often observed. Extensive peripheral retinotomy is required. The aim of our study is to present the results of relaxing retinotomy.
94 consecutive patients who underwent retinotomy for retinal redetachment in the silicone oil filled eyes were examined. Indications for this procedure were: proliferative vitreoretinopathy (81.1%), trauma (12.6%) and diabetic retinopathy (6.3%). These eyes were previously treated with scleral buckling, vitrectomy, membrane peeling and silicone tamponade without success.
After a minimum of 6 months follow-up, the retina was completely attached in 73 (76.8%) cases. Sixty three (66.3%) eyes achieved final visual acuity 1/50 or better, and 37 (38.9%) achieved visual acuity of 5/50 or better. If the size of retinotomy was < 180 degrees minimal visual acuity 5/50 was observed in 40% and if retinotomy size was 180 degrees-360 degrees this visual acuity was achieved in 38.7% of cases.
Retinotomy can be an effective procedure in cases of repeated retinal detachment in the silicone oil filled eyes. Both, timing of this procedure and extent of retinotomy have no influence on final functional results.
在硅油填充的玻璃体手术初步成功后，视网膜再次脱离的情况经常可见。这需要进行广泛的周边视网膜切开术。我们研究的目的是展示松解性视网膜切开术的结果。
对94例在硅油填充眼中因视网膜再次脱离而接受视网膜切开术的连续患者进行了检查。该手术的适应症为：增生性玻璃体视网膜病变（81.1%）、外伤（12.6%）和糖尿病视网膜病变（6.3%）。这些眼睛之前接受过巩膜扣带术、玻璃体切除术、膜剥除术和硅油填塞术，但均未成功。
经过至少6个月的随访，73例（76.8%）患者的视网膜完全复位。63只眼（66.3%）最终视力达到1/50或更好，37只眼（38.9%）视力达到5/50或更好。如果视网膜切开术的范围小于180度，40%的患者视力达到最低5/50；如果视网膜切开术范围为180度至360度，38.7%的患者达到该视力。
视网膜切开术对于硅油填充眼中反复发生的视网膜脱离可能是一种有效的手术方法。该手术的时机和视网膜切开术的范围对最终功能结果均无影响。
