Davis J L, Serfass M S, Lai M Y, Trask D K, Azen S P
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Fla., USA.
Arch Ophthalmol. 1995 Nov;113(11):1401-9. doi: 10.1001/archopht.1995.01100110061026.
To evaluate the safety and efficacy of 1000- and 5000-centistoke silicone oil as retinal tamponades for the treatment of retinal detachments secondary to necrotizing retinitis in patients with human immunodeficiency virus (HIV) infection.
A prospective observational study.
Community and university-based ophthalmology clinics.
Three hundred fifty patients with HIV infection, who had 407 eyes with retinal detachments secondary to necrotizing retinitis.
Vitrectomy surgery for retinal detachment with 1000- or 5000-centistoke silicone oil as the retinal tamponade.
Efficacy was measured both by anatomic success (defined as complete retinal attachment or macular attachment) and by visual acuity success (defined as preservation of visual acuity or ambulatory vision). Safety was determined by the rate of complications, including abnormal intraocular pressure and corneal and lens opacification.
At the last follow-up examination, the retina was completely attached in 287 (73%) of 393 eyes, the macula was attached in 370 eyes (94%), 268 eyes (68%) had ambulatory vision, and visual acuity was preserved in 219 (56%) of 388 eyes. Corneal opacification, hypotony, and silicone oil emulsification were present in 4%, 2%, and 1% of eyes, respectively. One eye had elevated intraocular pressure. Of the 57 patients who had both eyes treated, 35 died, of whom four (11%) had nonambulatory vision in both eyes. Of the 293 patients who had one eye treated, 122 died, of whom 44 (36%) died with nonambulatory vision in the treated eye. The median time to cataract was 192 days; to nonambulatory vision, 474 days; and to death, 204 days.
Silicone oil repair of retinal detachments in necrotizing retinitis is an efficacious and safe procedure that delays or prevents loss of vision in advanced HIV disease.
评估1000厘沲和5000厘沲硅油作为视网膜填塞物治疗人类免疫缺陷病毒（HIV）感染患者坏死性视网膜炎继发视网膜脱离的安全性和有效性。
一项前瞻性观察性研究。
社区和大学眼科诊所。
350例HIV感染患者，其407只眼患有坏死性视网膜炎继发的视网膜脱离。
采用1000厘沲或5000厘沲硅油作为视网膜填塞物进行玻璃体切除术治疗视网膜脱离。
疗效通过解剖学成功（定义为视网膜完全复位或黄斑复位）和视力成功（定义为视力保留或可步行视力）来衡量。安全性通过并发症发生率来确定，包括眼压异常以及角膜和晶状体混浊。
在最后一次随访检查时，393只眼中有287只（73%）视网膜完全复位，370只眼（94%）黄斑复位，268只眼（68%）有可步行视力，388只眼中有219只（56%）视力得以保留。角膜混浊、低眼压和硅油乳化分别出现在4%、2%和1%的眼中。有一只眼眼压升高。在57例双眼接受治疗的患者中，35例死亡，其中4例（11%）双眼均无可行走视力。在接受单眼治疗的293例患者中，122例死亡，其中44例（36%）在接受治疗的眼中无可行走视力时死亡。白内障发生的中位时间为192天；无可行走视力的中位时间为474天；死亡的中位时间为204天。
硅油修复坏死性视网膜炎的视网膜脱离是一种有效且安全的手术，可延缓或预防晚期HIV疾病患者视力丧失。
