Wolf Armin, Romano Mario R, Haritoglou Christos
Augenklinik, Universität Ulm, Prittwitzstr. 43, 89075, Ulm, Deutschland.
Humanitas University, Via Montalcini 4 20090 Pieve Emanuele, Mailand, Italien.
Ophthalmologie. 2022 Aug;119(8):781-788. doi: 10.1007/s00347-022-01702-7. Epub 2022 Aug 2.
Silicone oil is an established intraocular surgical aid, which enables the treatment of the most complex starting situations but no other alternative has been found; however, the available data indicate that an unclear loss of visual acuity during or after an intraocular silicone oil tamponade possibly occurs more frequently than assumed from the clinical routine. Various pathological mechanisms are under discussion as causes, but the exact causes are actually unclear. In addition to atrophic alterations in the optical coherence tomography (OCT) examination, there are a clear reduction in visual acuity and mostly a central scotoma with otherwise inconspicuous findings. Unclear loss of visual acuity can also occur after removal of the silicone oil. Whether this is caused by the same pathological mechanism is unclear. Furthermore, there are no reproducible risk factors that appear a priori to possibly cause an unclear loss of vision under silicone oil; however, oil removal as soon as possible and a good adjustment of the intraocular pressure are recommended by the authors. Overall, a silicone oil tamponade should be carefully weighed up even when using modern highly purified silicone oils and it should therefore continue to be reserved particularly for unfavorable initial situations or complicated courses with the necessity for a silicone oil tamponade. Against this background, a study for systematic recording and processing of cases of unclear loss of visual acuity after silicone oil tamponade seems to be meaningful.
硅油是一种成熟的眼内手术辅助材料，它能够用于处理最复杂的初始情况，但尚未找到其他替代材料；然而，现有数据表明，眼内硅油填充期间或之后出现不明原因的视力下降可能比临床常规认知的更为频繁。目前正在探讨各种病理机制作为病因，但确切原因实际上尚不清楚。除了光学相干断层扫描（OCT）检查中的萎缩性改变外，还存在视力明显下降，且大多伴有中心暗点，其他方面表现不明显。硅油取出后也可能出现不明原因的视力下降。这是否由相同的病理机制引起尚不清楚。此外，不存在可先验地导致硅油填充下不明原因视力丧失的可重复风险因素；然而，作者建议尽快取出硅油并良好地调节眼压。总体而言，即使使用现代高纯度硅油，也应仔细权衡硅油填充的利弊，因此尤其应继续保留用于不利的初始情况或需要硅油填充的复杂病程。在此背景下，一项对硅油填充后不明原因视力丧失病例进行系统记录和处理的研究似乎很有意义。
