Madreperla S A, McCuen B W
Retina Department, Duke University Eye Center, Durham, North Carolina 27710, USA.
Retina. 1995;15(2):87-90.
Silicone oil tamponade is used in treating retinal detachments, but silicone-associated complications remain frequent. Keratopathy and acute pupillary block glaucoma are related to migration of silicone oil into the anterior chamber. Since 1985, many surgeons have created an inferior peripheral iridectomy (PI) at the time of surgery to prevent forward migration of the oil, but the rate of postoperative closure of the PI and the effect on oil position have not been well defined.
The charts of 292 patients undergoing silicone oil surgery were reviewed. The status of the PI and the oil position were determined throughout the postoperative period.
Postoperative closure of the PI occurred in 40 (33%) of 121 aphakic eyes in the early postoperative period. Forward migration of the oil was highly associated with closure of the PI (32/40, 80%). Conversely, forward oil migration occurred in only 11% (9/81) of eyes with patent PIs. The rate of PI closure was significantly greater for patients with proliferative diabetic retinopathy (21/40, 52%) than for patients with proliferative vitreoretinopathy (11/58, 19%).
Postoperative closure of the PI occurred in a significant fraction of eyes undergoing silicone oil surgery, was highly correlated with forward oil migration, and occurred most frequently in eyes with proliferative diabetic retinopathy.
硅油填充术用于治疗视网膜脱离，但与硅油相关的并发症仍然很常见。角膜病变和急性瞳孔阻滞性青光眼与硅油向前房迁移有关。自1985年以来，许多外科医生在手术时进行了下方周边虹膜切除术（PI）以防止硅油向前迁移，但PI术后闭合率以及对油位置的影响尚未明确。
回顾了292例行硅油手术患者的病历。在整个术后期间确定PI的状态和油的位置。
121只无晶状体眼中有40只（33%）在术后早期发生了PI术后闭合。硅油向前迁移与PI闭合高度相关（32/40，80%）。相反，PI开放的眼中只有11%（9/81）发生了硅油向前迁移。增殖性糖尿病视网膜病变患者的PI闭合率（21/40，52%）显著高于增殖性玻璃体视网膜病变患者（11/58，19%）。
在接受硅油手术的相当一部分眼中发生了PI术后闭合，并与硅油向前迁移高度相关，且在增殖性糖尿病视网膜病变患者的眼中最常发生。
