Ophthalmology Department, Peking University Third Hospital, Beijing, P. R. China.
Can J Ophthalmol. 2013 Aug;48(4):307-11. doi: 10.1016/j.jcjo.2013.03.005.
To evaluate the effect of scleral buckling surgery on the treatment of hypotony caused by choroidal holes and suprachoroidal silicone oil (SO) migration following surgical procedures for open globe injuries.
Retrospective, consecutive, interventional case series.
Ten eyes of 10 patients with hypotony caused by choroidal holes with suprachoroidal SO migration and choroidal detachment after vitrectomy for open globe injuries between October 2009 and December 2010.
All cases clinically diagnosed as hypotony caused by choroidal holes with suprachoroidal SO migration and choroidal detachment were identified. Those eyes with retinal detachment, ciliary body damage, ciliary body fibrosis, or cyclodialysis cleft were excluded. Scleral buckling with or without suprachoroidal SO drainage was performed.
The mean preoperative intraocular pressure (IOP) was 6.7 ± 1.4 mm Hg (5.3-9.0 mm Hg). The mean final follow-up IOP was 12.2 ± 4.7 mm Hg (7.0-21.0 mm Hg; p = 0.005). In 7 eyes, the IOP increased to ≥10 mm Hg, whereas 3 eyes showed no significant IOP elevations. The choroidal hole was closed, and the range of choroidal detachment was significantly reduced in those 7 eyes. Although the choroidal hole was not fully closed in 3 eyes, the choroidal detachment area was less extensive, and the IOP was stable at approximately 7 mm Hg.
Scleral buckling surgery combined with suprachoroidal SO drainage is an effective way to manage hypotony caused by choroidal holes and suprachoroidal SO migration in a SO-filled eye after vitrectomy for open globe injuries.
评估巩膜扣带术治疗眼外伤玻璃体切除术后脉络膜裂孔伴脉络膜脱离及脉络膜下硅油(SO)迁移导致低眼压的效果。
回顾性、连续、干预性病例系列。
2009 年 10 月至 2010 年 12 月,10 例(10 眼)眼外伤玻璃体切除术后出现脉络膜裂孔伴脉络膜脱离及脉络膜下 SO 迁移导致低眼压患者。
所有患者均经临床诊断为眼外伤玻璃体切除术后出现脉络膜裂孔伴脉络膜脱离及脉络膜下 SO 迁移导致的低眼压。排除伴有视网膜脱离、睫状体损伤、睫状体纤维化或睫状体分离的患者。行巩膜扣带术联合或不联合脉络膜下 SO 引流术。
术前平均眼压(IOP)为 6.7±1.4mmHg(5.3-9.0mmHg)。末次随访时平均眼压为 12.2±4.7mmHg(7.0-21.0mmHg;p=0.005)。7 只眼的眼压升高至≥10mmHg,3 只眼眼压无明显升高。7 只眼的脉络膜裂孔闭合,脉络膜脱离范围明显缩小。虽然 3 只眼的脉络膜裂孔未完全闭合,但脉络膜脱离面积较小,眼压稳定在 7mmHg 左右。
巩膜扣带术联合脉络膜下 SO 引流术是治疗眼外伤玻璃体切除术后硅油填充眼脉络膜裂孔伴脉络膜下 SO 迁移导致低眼压的有效方法。