硅油取出术后裂孔源性视网膜脱离：不同技术的比较。
Silicone oil removal after rhegmatogenous retinal detachment: comparing techniques.
机构信息
Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
出版信息
Eye (Lond). 2012 Mar;26(3):444-7. doi: 10.1038/eye.2011.319. Epub 2011 Dec 9.
PURPOSE
To assess the outcome of silicone oil removal after rhegmatogenous retinal detachment (RRD) surgery, and to compare results of a two-port (infusion-extraction) versus a three-port (full vitrectomy) approach.
METHODS
Primary outcome measure was the rate of redetachment. Secondary outcome measures were visual acuity, rate of intraoperative and postoperative epiretinal membrane removal and complications.
RESULTS
We included 147 consecutive cases. There were 15 cases of giant retinal tear, 26 cases of RRD without proliferative vitreoretinopathy (PVR) and 106 cases of RRD with PVR. The overall redetachment rate after silicone oil removal was 17.7%. In the group treated with the two-port technique (n=95), the retina redetached in 16 cases (16.8%), and in the group treated with the three-port technique (n=52), redetachment occurred in 10 cases (19.2%). This difference was not statistically significant (P=0.717; χ (2)-test). There was a significantly higher redetachment rate in cases with a short oil tamponade duration of <2 months.
CONCLUSION
We reconfirm a relatively high redetachment rate after silicone oil removal. The risk of redetachment is not lower with the three-port compared with the two-port approach.
目的
评估孔源性视网膜脱离（RRD）手术后硅油取出的结果，并比较两孔（注吸）与三孔（全玻璃体切除术）方法的结果。
方法
主要观察指标为再脱离率。次要观察指标为视力、术中及术后视网膜内膜去除率及并发症。
结果
我们纳入了 147 例连续病例。其中 15 例为巨大裂孔，26 例为无增生性玻璃体视网膜病变（PVR）的 RRD，106 例为 PVR 的 RRD。硅油取出后总的再脱离率为 17.7%。在采用两孔技术治疗的 95 例患者中，16 例（16.8%）视网膜再脱离，而在采用三孔技术治疗的 52 例患者中，10 例（19.2%）视网膜再脱离。这一差异无统计学意义（P=0.717；卡方检验）。硅油填充时间<2 个月的患者再脱离率明显较高。
结论
我们再次证实硅油取出后再脱离率相对较高。与两孔方法相比，三孔方法并不会降低再脱离的风险。
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