Hutton W L, Azen S P, Blumenkranz M S, Lai M Y, McCuen B W, Han D P, Flynn H W, Ramsay R C, Ryan S J
Texas Retina Associates, Dallas.
Arch Ophthalmol. 1994 Jun;112(6):778-85. doi: 10.1001/archopht.1994.01090180076038.
To evaluate the advisability of removing silicone oil from eyes after surgery for severe (with a classification of at least C-3) proliferative vitreoretinopathy.
Subgroup analysis of the Silicone Study, a randomized, multicentered, surgical trial.
Community- and university-based clinics.
Two hundred twenty-two eyes with severe proliferative vitreoretinopathy followed up in the Silicone Study.
Vitrectomy for proliferative vitreoretinopathy with silicone oil as the intraocular tamponade.
Changes in visual acuity, recurrent retinal detachment, and incidence of complications.
Ninety-nine (45%) of 222 eyes had surgery for silicone oil removal (oil-removed eyes). Compared with the eyes that did not undergo silicone oil removal (oil-retained eyes) evaluated at a comparable time after oil injection, oil-removed eyes at the examination prior to oil removal were more likely to be attached (85% vs 40%; P < .0001), have a visual acuity of 5/200 or greater (63% vs 35%; P < .0001), and not be hypotonous (5% vs 22%; P < .001). There was no association between the length of oil retention and incidence of recurrent retinal detachment after oil removal. Eyes with attached retinas at the time of oil removal generally improved in visual acuity at the last follow-up examination (P < .0001), which was not evident in eyes with detached retinas at the time of oil removal. In a matched-pair cohort analysis comparing both sets of eyes, there was an increased risk for recurrent retinal detachment at the last follow-up examination in the oil-removed eyes (odds ratio [OR], 2.1; P = .09). However, overall visual acuity improved for oil-removed eyes in 19 (29%) of 66 pairs and for oil-retained eyes in one (2%) of 66 pairs (OR, 19.0; P < .0001). Although nonsignificant, incidence rates of keratopathy (OR, 0.5) and hypotony (OR, 0.5) were lower in oil-removed eyes.
Removal of silicone oil in anatomically successful eyes significantly increases the likelihood of improved visual acuity with a slight increase in the likelihood of recurrent retinal redetachment. There was a trend for a reduction in the incidence of complications in the oil-removed eyes.
评估在严重（至少为C-3级）增生性玻璃体视网膜病变手术后从眼中取出硅油的合理性。
硅油研究的亚组分析，这是一项随机、多中心的外科试验。
社区和大学诊所。
硅油研究中随访的222只患有严重增生性玻璃体视网膜病变的眼睛。
采用硅油作为眼内填充物进行增生性玻璃体视网膜病变的玻璃体切除术。
视力变化、视网膜脱离复发情况及并发症发生率。
222只眼中有99只（45%）接受了硅油取出手术（取油眼）。与在硅油注射后可比时间评估的未进行硅油取出的眼睛（留油眼）相比，取油眼在取油前检查时更可能视网膜附着（85%对40%；P <.0001），视力为5/200或更好（63%对35%；P <.0001），且眼压不低（5%对22%；P <.001）。硅油留存时间与取油后视网膜脱离复发率之间无关联。取油时视网膜附着的眼睛在最后一次随访检查时视力通常有所改善（P <.0001），而取油时视网膜脱离的眼睛则不明显。在比较两组眼睛的配对队列分析中，取油眼在最后一次随访检查时视网膜脱离复发的风险增加（优势比[OR]，2.1；P =.09）。然而，在66对中，取油眼的整体视力在19对（29%）中得到改善，留油眼在66对中的1对（2%）中得到改善（OR，19.0；P <.0001）。虽然不显著，但取油眼的角膜病变发生率（OR，0.5）和低眼压发生率（OR，0.5）较低。
在解剖结构成功的眼中取出硅油显著增加了视力改善的可能性，同时视网膜再次脱离的可能性略有增加。取油眼的并发症发生率有降低趋势。
