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复杂视网膜脱离手术中1000厘沲与5000厘沲硅油的比较

Comparison of 1000-Centistoke versus 5000-Centistoke Silicone Oil in Complex Retinal Detachment Surgery.

作者信息

Zafar Shakir, Shakir Munira, Mahmood Syed Asaad, Amin Saima, Iqbal Zafar

机构信息

Department of Ophthalmology, LRBT Free Base Eye Hospital, Korangi, Karachi.

出版信息

J Coll Physicians Surg Pak. 2016 Jan;26(1):36-40.

Abstract

OBJECTIVE

To compare the efficacy and complications of using 1000-centistoke versus 5000-centistoke silicone oil for complex retinal detachment repair.

STUDY DESIGN

Case series.

PLACE AND DURATION OF STUDY

LRBT Tertiary Eye Hospital, Karachi, from January 2007 to June 2013.

METHODOLOGY

Eighty-five eyes (85 patients) presenting with superior rhegmatogenous retinal detachments associated with PVR grades B and C (involving not more than 3 clock hours) were randomized to either 1000 centistokes (n=44) or 5000 centistokes (n=41) silicone oil group. All patients underwent 23-gauge pars plana vitrectomy surgery with silicone oil intraocular tamponade. Patient data was analysed at 18 months post-operatively. IBM SPSS 21 was used for data analysis.

RESULTS

There were 52 male and 33 female patients aged between 22 and 70 years (45.2 ±16.2). After the first surgery, successful reattachment of the retina was achieved in 67 eyes (78.8%); of which 35 eyes were in 1000-centistoke and 32 eyes in 5000-centistoke groups. Mean pre-operative Best Corrected Visual Acuity (BCVA) was 1.63 ±0.54 which was improved to a mean post-operative BCVAof 1.46 ±0.78 (1.42 ±0.74 in 1000-centistoke group; 1.49 ±0.78 in 5000 centistoke group). The 1000-centistoke group had a significantly higher frequency of oil emulsification which necessitated early removal of silicone oil. There were 66 eyes (77%) with at least one complication (34 eyes in 1000-centistoke group; 32 eyes in 5000-centistoke group) including cataract, corneal abnormalities, raised IOP, hypotony, vitreous haemorrhage and retinal redetachment.

CONCLUSION

Although visual and anatomical outcomes were comparable between the two groups, the 1000-centistoke silicone oil group developed early oil emulsification necessitating its early removal.

摘要

目的

比较使用1000厘沲与5000厘沲硅油进行复杂视网膜脱离修复的疗效及并发症。

研究设计

病例系列研究。

研究地点及时间

卡拉奇LRBT三级眼科医院,2007年1月至2013年6月。

方法

85例(85只眼)患有与B级和C级增殖性玻璃体视网膜病变(累及不超过3个钟点)相关的上方孔源性视网膜脱离患者被随机分为1000厘沲(n = 44)或5000厘沲(n = 41)硅油组。所有患者均接受23G经平坦部玻璃体切除术及硅油眼内填充。术后18个月对患者数据进行分析。使用IBM SPSS 21进行数据分析。

结果

共有52例男性和33例女性患者,年龄在22至70岁之间(45.2±16.2)。首次手术后,67只眼(78.8%)视网膜成功复位;其中1000厘沲组35只眼,5000厘沲组32只眼。术前平均最佳矫正视力(BCVA)为1.63±0.54,术后平均BCVA提高至1.46±0.78(1000厘沲组为1.42±0.74;5000厘沲组为1.49±0.78)。1000厘沲组硅油乳化发生率显著更高,需要早期取出硅油。66只眼(77%)至少出现一种并发症(1000厘沲组34只眼;5000厘沲组32只眼),包括白内障、角膜异常、眼压升高、低眼压、玻璃体积血和视网膜再脱离。

结论

虽然两组的视力和解剖学结果相当,但1000厘沲硅油组出现早期硅油乳化,需要早期取出。

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