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硅油取出术后复杂视网膜脱离手术的结果

Outcome of complex retinal detachment surgery after silicone oil removal.

作者信息

Unlü Nurten, Kocaoğlan Hülya, Acar Mehmet A, Sargin Müge, Aslan Bekir S, Duman Sunay

机构信息

Ankara Training and Research Hospital, Ophthalmology Department, Ankara, Turkey.

出版信息

Int Ophthalmol. 2004 Jan;25(1):33-6. doi: 10.1023/b:inte.0000018545.62455.ff.

Abstract

BACKGROUND AND OBJECTIVE

To evaluate anatomical prognosis after silicone oil removal.

PATIENT AND METHODS

Sixty-eight eyes which underwent silicone oil removal were enrolled into the study. The underlying ocular pathology for pars plana vitrectomy, surgical methods, and time of silicone oil removal were analysed.

RESULTS

Sixteen of 68 eyes (23.5%) redetached following the removal of silicone oil. According to etiology redetachment rates: PVR C 9.5% (2/21), PVR D 25% (4/16), trauma without intraocular foreign body 27.3% (3/11), with intraocular foreign body 33.3% (2/6), giant retinal tear 37.5% (3/8), and proliferative diabetic retinopathy with tractional retinal detachment 33.3% (2/6). The rate of redetachment was 22% in patients with encircling band and 27.8% without encircling band. Retina was redetached in the first 10 days in 81.3% of patients after silicone oil removal.

CONCLUSION

The residual vitreoretinal traction especially at the vitreous base is the most likely reason for retinal redetachment after silicone oil removal, which is most commonly seen during the first 10 days.

摘要

背景与目的

评估硅油取出术后的解剖学预后情况。

患者与方法

68只接受硅油取出术的眼睛纳入本研究。分析了行玻璃体视网膜手术的潜在眼部病变、手术方法及硅油取出时间。

结果

68只眼中有16只(23.5%)在硅油取出后视网膜再次脱离。根据病因,视网膜再次脱离的发生率:增殖性玻璃体视网膜病变C级9.5%(2/21),增殖性玻璃体视网膜病变D级25%(4/16),无眼内异物的外伤27.3%(3/11),有眼内异物的外伤33.3%(2/6),巨大视网膜裂孔37.5%(3/8),增殖性糖尿病视网膜病变伴牵引性视网膜脱离33.3%(2/6)。有环扎带的患者视网膜再次脱离发生率为22%,无环扎带的患者为27.8%。81.3%的患者在硅油取出后的前10天内视网膜再次脱离。

结论

硅油取出术后视网膜再次脱离最可能的原因是残留的玻璃体视网膜牵引,尤其是在玻璃体基底部,这在术后前10天最为常见。

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