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硅油取出术在增生型糖尿病视网膜病变中的应用-长期随访。

Silicone oil removal after extended tamponade in proliferative diabetic retinopathy-a long range of follow-up.

机构信息

Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Eye (Lond). 2020 Dec;34(12):2307-2314. doi: 10.1038/s41433-020-0815-2. Epub 2020 Feb 18.

Abstract

BACKGROUND

To investigate the anatomical and functional results of silicone oil (SO) removal after an extended period of SO tamponade in eyes having received vitrectomy for proliferative diabetic retinopathy (PDR).

METHODS

From May 2009 to August 2017, clinical records of patients who had vitrectomy for PDR and underwent SO removal were retrospectively reviewed. SO was in principle left in the eye for an extended period of time and would be removed promptly when complications relevant to SO rose, or at the same setting when other intraocular surgeries were performed. Main outcome measures include anatomical outcome, functional outcome, and postoperative complications.

RESULTS

Seventy-four eyes of 64 patients (31 males and 33 females) were analysed. The mean follow-up duration was 35.6 months (ranging from 6 to 99 months, median 32 months). The duration of SO tamponade ranged from 3 to 116 months (mean 26.89 months, median 16 months). Anatomical success was achieved in 95.9% at the last follow-up with best-corrected visual acuity (BCVA) becoming better or unchanged in 81.1%. Postoperative complications included ocular hypertension (>25 mmHg; > 4 weeks) in three eyes (4.1%), macular hole in two eyes (2.7%), transient choroidal detachment in one eye (1.4%), vitreous haemorrhage in four eyes (5.4%) and hyphaema in two eyes (2.7%).

CONCLUSIONS

The rate of retinal redetachment after an extended period of SO tamponade and removal was low and the majority of eyes obtained final visual acuity improvement. SO removal after an extended period of tamponade in PDR seems to be safe under proper indications and case selection.

摘要

背景

研究在增生性糖尿病视网膜病变(PDR)玻璃体切除术后接受硅油(SO)延长填塞的眼睛中去除 SO 后的解剖和功能结果。

方法

从 2009 年 5 月至 2017 年 8 月,回顾性分析了接受 PDR 玻璃体切除术并接受 SO 去除术的患者的临床记录。原则上,SO 会在眼睛中保留很长时间,当与 SO 相关的并发症出现时,或者在进行其他眼内手术时,会迅速将其取出。主要观察指标包括解剖结果、功能结果和术后并发症。

结果

74 只眼 64 例(31 例男性,33 例女性)纳入分析。平均随访时间为 35.6 个月(6-99 个月,中位数 32 个月)。SO 填塞时间为 3-116 个月(平均 26.89 个月,中位数 16 个月)。末次随访时,95.9%的眼达到解剖成功,最佳矫正视力(BCVA)较术前改善或无变化的占 81.1%。术后并发症包括 3 只眼(4.1%)眼压升高(>25mmHg;>4 周)、2 只眼(2.7%)黄斑裂孔、1 只眼(1.4%)一过性脉络膜脱离、4 只眼(5.4%)玻璃体积血和 2 只眼(2.7%)前房积血。

结论

在延长的 SO 填塞和取出后视网膜再脱离的发生率较低,大多数眼获得了最终的视力改善。在适当的适应证和病例选择下,PDR 中延长填塞后取出 SO 似乎是安全的。

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