St Paul's Eye Unit, Royal Liverpool University Hospital, Link 8z, Prescot Street, Liverpool, L7 8XP, UK.
Graefes Arch Clin Exp Ophthalmol. 2012 May;250(5):645-52. doi: 10.1007/s00417-011-1873-8. Epub 2011 Dec 4.
Silicone oil (SO) is an established tamponade in treating complex vitreoretinal diseases. Although SO is intended to be removed after several weeks to months, permanent SO might be unavoidable in a small subgroup of patients with an extremely complicated clinical course. The aim of this study is to describe the long-term effects of intraocular SO tamponade.
This retrospective study included 50 patients with intraocular SO (Oxane 5700 Bausch & Lomb, Kingston-upon-Thames, UK) for at least 12 months. The most common reasons for long-term SO tamponade were: retinal re-detachment (re-RD), proliferative diabetic retinopathy (PDR), ocular trauma, and persistent hypotony.
Mean age was 59.2 ± 18.4 years, and mean duration of silicone oil in the eye was 54.5 ± 58.6 months (median, 30 months). The average number of previous surgeries were 2.2 ± 1.5. Anatomic success was achieved in 37/50 (74%) of patients. Visual acuities (logMAR) were 1.8 ± 0.6, 1.6 ± 0.6, 2 ± 0.7 and intraocular pressures (mmHg) were 15.6 ± 7, 15.7 ± 5.5, 16.5 ± 7.1 at 3 months, 1 year and at last follow-up respectively. The main long-term silicone-oil-related complications observed were: band keratopathy (8%), corneal decompensation (12%), iris rubeosis (14%), and optic neuropathy (28%). Forty percent of patients achieved ambulatory vision in the SO-filled eye at final follow-up.
Long-term silicone oil can be a last-resort option in selected patients with severe vitreoretinal disease. Anterior and posterior segment complications did occur at significant rates. Forty percent of our patients maintained ambulatory vision. The actual number of patients that achieved satisfactory stereopsis and benefited functionally from long-term SO was much less [7/50 (14%)].
硅油(SO)是治疗复杂玻璃体视网膜疾病的一种成熟的眼内填充物。尽管 SO 旨在数周至数月后取出,但对于一小部分临床过程极其复杂的患者,永久性 SO 可能是不可避免的。本研究旨在描述眼内 SO 填充物的长期效果。
本回顾性研究纳入了 50 例眼内 SO(Oxane 5700,Bausch & Lomb,英国金斯敦)填充至少 12 个月的患者。长期 SO 填充的最常见原因是:视网膜再脱离(re-RD)、增殖性糖尿病视网膜病变(PDR)、眼外伤和持续性低眼压。
患者平均年龄为 59.2±18.4 岁,眼内硅油的平均持续时间为 54.5±58.6 个月(中位数 30 个月)。平均手术次数为 2.2±1.5 次。37/50(74%)的患者达到解剖学成功。视力(logMAR)分别为 1.8±0.6、1.6±0.6、2±0.7,眼压(mmHg)分别为 15.6±7、15.7±5.5、16.5±7.1,分别在术后 3 个月、1 年和最后一次随访时测量。观察到的主要长期与 SO 相关的并发症有:带状角膜病变(8%)、角膜失代偿(12%)、虹膜红变(14%)和视神经病变(28%)。40%的患者在最后一次随访时在充满 SO 的眼中达到了可走动视力。
对于患有严重玻璃体视网膜疾病的选定患者,长期使用 SO 可能是最后的选择。前节和后节并发症的发生率均较高。我们的 40%的患者保持了可走动视力。实际上,通过长期 SO 获得满意的立体视觉和功能受益的患者数量要少得多[7/50(14%)]。