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硅油取出:预后因素与视网膜再脱离的发生率。

Removal of silicone oil: prognostic factors and incidence of retinal redetachment.

机构信息

Cleveland Clinic Foundation, Cleveland, Ohio, USA.

出版信息

Retina. 2012 Nov-Dec;32(10):2034-8. doi: 10.1097/IAE.0b013e3182562045.

DOI:10.1097/IAE.0b013e3182562045
PMID:22653544
Abstract

PURPOSE

To evaluate the incidence of retinal redetachment after the removal of silicone oil endotamponade for complicated retinal detachment and identify possible factors affecting outcome.

METHODS

This is a retrospective review of 173 patients who underwent pars plana vitrectomy with silicone oil tamponade for complex retinal detachment and subsequent removal of silicone oil (ROSO). The outcome factors studied included anatomical success, best-corrected visual acuity and intraocular pressure pre- and post-ROSO.

RESULTS

Anatomical success was achieved in 167 of the 173 eyes (96.5%) after ROSO. The mean duration of silicone oil tamponade was 70 ± 48 weeks (median, 56 weeks; mode, 48 weeks). The cause for primary retinal detachment was proliferative diabetic retinopathy in 36 (20.8%) and proliferative vitreoretinopathy in 137 of 173 cases (79.2%). Best-corrected visual acuity of greater than 20/100 was achieved in 83 cases (49.4%) at 3 months after ROSO. Levene's test for equality of variances was used to determine the association between previous unsuccessful retinal surgeries and redetachment (P = 0.523) and between duration of endotamponade and anatomical success (P = 0.451).

CONCLUSION

The incidence of retinal redetachment after ROSO in our study was 3.46%. Aggressive removal of the vitreous base, performing retinotomies, ensuring complete silicone oil filling for adequate tamponade, and argon retinopexy can lead to low complication rates and improved outcomes.

摘要

目的

评估复杂性视网膜脱离经硅油内填充取出术后视网膜再脱离的发生率,并确定可能影响结果的因素。

方法

这是一项回顾性研究,纳入 173 例行玻璃体切除术联合硅油填充治疗复杂性视网膜脱离并随后行硅油取出术(ROSO)的患者。研究的转归因素包括解剖复位成功率、最佳矫正视力和 RO-SO 前后的眼压。

结果

ROSO 后 173 只眼中有 167 只(96.5%)达到解剖复位成功。硅油填充的平均时间为 70±48 周(中位数 56 周;模式 48 周)。初次视网膜脱离的原因是增殖性糖尿病视网膜病变 36 只眼(20.8%)和增殖性玻璃体视网膜病变 137 只眼(79.2%)。ROSO 后 3 个月,83 只眼(49.4%)获得了大于 20/100 的最佳矫正视力。Levene 方差齐性检验用于确定先前视网膜手术失败与再脱离之间的关系(P=0.523)和内填充时间与解剖复位成功率之间的关系(P=0.451)。

结论

本研究中 ROSO 后视网膜再脱离的发生率为 3.46%。积极切除玻璃体基底部、行视网膜切开术、确保硅油完全填充以充分填塞、氩激光视网膜光凝可降低并发症发生率,改善预后。

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