Cheung Benson T O, Lai Timothy Y Y, Yuen Can Y F, Lai Wico W K, Tsang Chi-Wai, Lam Dennis S C
Hong Kong Eye Hospital, 147K, Argyle Street, Kowloon, Hong Kong.
Br J Ophthalmol. 2007 Jun;91(6):719-21. doi: 10.1136/bjo.2006.111526. Epub 2007 Jan 17.
To evaluate the use of high-density silicone oil (HDSO) as a tamponade agent for retinal detachment secondary to myopic macular hole.
12 eyes of 12 patients with macular hole retinal detachment underwent pars plana vitrectomy, internal limiting membrane peeling and HDSO tamponade. No posturing was required postoperatively and HDSO was removed 3-4 months later. Outcome measures included macular hole closure and retinal attachment rates, best-corrected visual acuity (BCVA), and intraoperative and postoperative complications.
The mean age of the patients was 67.8 years and the mean spherical equivalent refractive error was -13.4 diopters. After the removal of HDSO, 10 (83%) eyes had macular hole closure with retinal reattachment without any tamponade. One eye had retinal reattachment after re-operation and the other refused further surgery. At the last follow-up, the median BCVA improved from 20/800 to 20/600 (p = 0.046). A transient increase in intraocular pressure was observed in 5 (42%) eyes and one eye each developed mild oil emulsification and transient peripheral choroidal detachment. None of the eyes was found to have severe intraocular inflammation postoperatively.
HDSO seemed to be an effective tamponade agent for myopic macular hole retinal detachment. Further prospective controlled studies seem warranted.
评估高密度硅油（HDSO）作为近视性黄斑裂孔继发视网膜脱离的填塞剂的应用。
12例黄斑裂孔性视网膜脱离患者的12只眼接受了玻璃体切割术、内界膜剥除术及HDSO填塞。术后无需体位护理，3 - 4个月后取出HDSO。观察指标包括黄斑裂孔闭合率、视网膜复位率、最佳矫正视力（BCVA）以及术中及术后并发症。
患者平均年龄67.8岁，平均等效球镜度数为-13.4屈光度。取出HDSO后，10只眼（83%）黄斑裂孔闭合且视网膜复位，无需任何填塞。1只眼再次手术后视网膜复位，另1只眼拒绝进一步手术。在最后一次随访时, 中位BCVA从20/800提高到20/600（p = 0.046）。5只眼（42%）观察到眼压短暂升高，1只眼出现轻度油乳化和短暂的周边脉络膜脱离。术后未发现眼内有严重炎症。
HDSO似乎是治疗近视性黄斑裂孔性视网膜脱离的一种有效填塞剂。进一步的前瞻性对照研究似乎是必要的。
