Acar Mehmet A, Ünlü Nurten, Hazirolan Dicle, Demir M Necati, Üney Güner Ö, Örnek Firdevs
Department of Ophthalmology, Ankara Research and Training Hospital, Ministry of Health, Ankara, Turkey.
Eur J Ophthalmol. 2011 May-Jun;21(3):290-5. doi: 10.5301/EJO.2010.5749.
To evaluate the anatomic and functional outcomes of conventional surgery in silicone oil (SO)-filled eyes with complicated retinal detachment (RD).
The records of patients who underwent scleral buckling surgery for complex RD in SO-filled eyes were retrospectively reviewed. Conventional RD surgery involved a 2.5-mm encircling band, 6-mm silicone strip for the inferior quadrants or local sponge implant, subretinal fluid (SRF) drainage, and/or SO aspiration with a 27-G needle. Cryotherapy and/or laser photocoagulation was applied around the tears and 360° of the peripheral retina.
In all, 4 of the cases had retinal breaks in the lower quadrants, 1 of which had a macular hole; recurrence was due to proliferative vitreoretinopathy (PVR) in the 3 other cases. Three cases were treated with external SRF drainage, 3 cases with SO aspiration, and 1 case with both external drainage and SO aspiration. The retina was attached at the last follow-up visit in 6 (85.7%) of the 7 eyes. One of the cases required secondary vitreoretinal surgery for recurrent RD due to PVR and still had SO tamponade at last follow-up visit. Mean follow-up period was 17.28 ± 8.64 months. Mean logMAR visual acuity was 1.47 ± 0.47 preoperatively and 1.4 ± 0.97 postoperatively.
Inferior RD in eyes treated with silicone oil tamponade, with or without a retinal break, can be treated with scleral buckling surgery, external SRF drainage, and/or pars plana SO aspiration with satisfactory functional and anatomic outcomes in selected complicated RD cases.
评估硅油(SO)填充眼合并复杂性视网膜脱离(RD)行传统手术的解剖和功能结局。
回顾性分析硅油填充眼行巩膜扣带术治疗复杂性视网膜脱离患者的病历。传统视网膜脱离手术包括使用2.5毫米环扎带、6毫米硅胶条用于下方象限或局部海绵植入、视网膜下液(SRF)引流和/或用27G针头抽吸硅油。在裂孔周围及周边视网膜360°进行冷冻治疗和/或激光光凝。
总共4例下方象限有视网膜裂孔,其中1例有黄斑裂孔;其他3例复发是由于增殖性玻璃体视网膜病变(PVR)。3例行视网膜下液外引流,3例行硅油抽吸,1例行视网膜下液外引流联合硅油抽吸。7只眼中6只(85.7%)在最后一次随访时视网膜复位。其中1例因PVR导致视网膜脱离复发需行二期玻璃体视网膜手术,最后一次随访时仍有硅油填充。平均随访时间为17.28±8.64个月。术前平均logMAR视力为1.47±0.47,术后为1.4±0.97。
对于硅油填充眼的下方视网膜脱离,无论有无视网膜裂孔,在选定的复杂性视网膜脱离病例中,巩膜扣带术、视网膜下液外引流和/或经平坦部硅油抽吸治疗可获得满意的功能和解剖结局。