Ghoraba Hamouda Hamdy, Zaky Adel Galal, Heikal Mohamed Amin, Elgemai Emad Eldin Mohamed, Abd Al Fatah Haithem Mamoun
Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Ophthalmologica. 2017;238(1-2):59-67. doi: 10.1159/000470857. Epub 2017 Apr 27.
Silicone oil (SO) is used as an intravitreal tamponade agent in vitreoretinal surgery for rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy or with large, multiple retinal tears. Usually, SO is left in the eye for at least 3 months. Although its use can lead to well-known complications, intraocular SO is generally well tolerated. Some studies have reported unexpected central vision loss after SO use or removal.
To investigate and analyze the reason for visual loss after the use or removal of intraocular SO in patients who underwent vitrectomy surgeries for RRD.
A retrospective observational case series of 12 patients with macula-on RRD who reported visual loss after the use or removal of SO was reviewed. Investigations carried out included fundus fluorescein angiography, optical coherence tomography (OCT) of the macula and optic disc, perimetry, and electrophysiological study. Electrolyte levels were measured in retro-oil fluid and compared with their levels in the vitreous humor of patients who underwent vitrectomy for macular holes, floaters, dropped intraocular lenses, or dropped crystalline lens fragments.
Visual acuity levels dropped by at least 2 Snellen chart lines. None of the 12 cases had macular detachment at any stage. Fundus fluorescein angiography and OCT results were unremarkable in most of the cases. Mean levels of electrolytes in retro-oil fluids and vitreous humor were similar.
Visual loss is a possible complication after SO use or removal. This still remains a mysterious issue which needs further research and investigation.
硅油（SO）在玻璃体视网膜手术中用作玻璃体腔填充剂，用于治疗伴有增生性玻璃体视网膜病变或有大量、多发性视网膜裂孔的孔源性视网膜脱离（RRD）。通常，硅油会在眼内留存至少3个月。尽管其使用会导致一些众所周知的并发症，但眼内硅油一般耐受性良好。一些研究报告了使用或取出硅油后出现意外的中心视力丧失。
调查和分析接受RRD玻璃体切除术的患者在使用或取出眼内硅油后视力丧失的原因。
回顾性观察了12例黄斑在位的RRD患者，这些患者在使用或取出硅油后报告了视力丧失。进行的检查包括眼底荧光血管造影、黄斑和视盘的光学相干断层扫描（OCT）、视野检查和电生理研究。测量了硅油后房液中的电解质水平，并与接受黄斑裂孔、飞蚊症、人工晶状体脱位或晶状体碎片脱位玻璃体切除术患者的玻璃体液中的电解质水平进行了比较。
视力至少下降2行Snellen视力表。12例患者在任何阶段均无黄斑脱离。大多数病例的眼底荧光血管造影和OCT结果无明显异常。硅油后房液和玻璃体液中的电解质平均水平相似。
使用或取出硅油后视力丧失是一种可能的并发症。这仍然是一个需要进一步研究和调查的神秘问题。
