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复杂视网膜脱离硅油取出术的预后

Outcomes of Silicone Oil Removal in Complex Retinal Detachment.

作者信息

Shah Ritesh, Byanju Raghunandan, Pradhan Sangita

机构信息

Bharatpur Eye Hospital, Bharatpur, Nepal.

出版信息

Nepal J Ophthalmol. 2018 Jul;10(20):124-129. doi: 10.3126/nepjoph.v10i2.23012.

Abstract

INTRODUCTION

Pars plana vitrectomy in combination with intraocular tamponade with silicone oil is a standard technique in the treatment of complex retinal detachment. Although the use of silicone oil has improved the results of retinal detachment surgery, its removal is recommended due to the ocular complications related to its long term use. However, retinal redetachment can occur after silicone oil removal.

OBJECTIVE

To evaluate the anatomical and visual outcome after silicone oil removal (SOR) in eyes with complicated retinal detachment.

MATERIAL AND METHODS

We retrospectively analyzed 64 eyes of 64 consecutive patients of silicone oil removal over a period of 12 months. All eyes had undergone standard 3 ports pars plana vitrectomy with silicone oil placement for complicated retinal detachment. Cases that completed at least 1 month follow up duration after SOR were included in the study. Anatomical success after SOR was achieved in 56 of 64 eyes (87.5%). Seven of 8 redetachments (87.5%) were seen in eyes with silicone oil tamponade duration of less than 6 months. Visual acuity improved or was stabilized in 49 of 64 eyes (76.6%). Using paired T-test, it was found that there was no significant difference in pre and post SOR visual acuity. Postoperative ocular hypertension, corneal decompensation, band shaped keratopathy and hypotony was observed in 9.4%, 4.7%, 6.4% and 21.9% respectively.

CONCLUSION

Although there was no significant improvement in visual acuity, redetachment and complication rates were comparable to other studies. The duration of endotamponade was not significantly associated with the redetachment rate. Key words: Silicone oil removal, Redetachment, Visual outcome, Keratopathy, ocular hypertension.

摘要

引言

玻璃体切除术联合硅油眼内填充是治疗复杂性视网膜脱离的标准技术。尽管硅油的使用改善了视网膜脱离手术的效果,但因其长期使用会引发眼部并发症,故建议取出。然而,取出硅油后视网膜可能会再次脱离。

目的

评估复杂性视网膜脱离患者硅油取出术后的解剖和视力预后。

材料与方法

我们回顾性分析了连续12个月内64例患者的64只接受硅油取出术的眼睛。所有眼睛均因复杂性视网膜脱离接受了标准的三通道玻璃体切除术并填充硅油。纳入研究的病例为硅油取出术后至少随访1个月的患者。64只眼中有56只(87.5%)硅油取出术后解剖复位成功。8例再次脱离的眼中有7例(87.5%)硅油填充时间少于6个月。64只眼中有49只(76.6%)视力改善或稳定。采用配对t检验发现,硅油取出术前和术后的视力无显著差异。术后分别有9.4%、4.7%、6.4%和21.9%的患者出现高眼压、角膜失代偿、带状角膜病变和低眼压。

结论

尽管视力无显著改善,但再次脱离率和并发症发生率与其他研究相当。眼内填充时间与再次脱离率无显著相关性。关键词:硅油取出;再次脱离;视力预后;角膜病变;高眼压

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