Nawrocki J, Ghoraba H, Gabel V P
Tanta University, Tanta, Agypten.
Ophthalmologe. 1993 Jun;90(3):258-63.
Silicone oil is used in the treatment of complex retinal detachments, but late complications have been reported by many authors. Silicone oil removal (SOR) is therefore performed in order to reduce these complications. SOR was investigated in 63 consecutive cases. All these eyes had had a totally attached retina for at least 3 months before SOR was performed, there were no signs of traction or reproliferation, and the minimum vision was 4/200. The duration of silicone oil tamponade was less than 6 months in 13 eyes, 6-12 months in 18 and more than 1 year in 32 eyes. In post-traumatic and diabetic cases it was possible to remove silicone oil after 8 to 10 months and in PVR cases after 14 months. Redetachment of the retina was the most frequent complication of SOR, appearing in 18/63 eyes; 16 of them were refilled. In 9 eyes, the visual acuity present before silicone oil removal was reestablished. The redetachment rate was similar in PVR, diabetes and trauma cases and had no correlation with the duration of silicone oil tamponade. Increased intraocular pressure was observed in 13 eyes before SOR but it returned to normal levels afterwards in 8 cases without further surgery. The results of our study show that even if the indication is established very carefully, SOR results in a relatively high rate of complications, such as redetachment of the retina. Therefore every case undergoing this procedure must be evaluated in detail.
硅油被用于治疗复杂性视网膜脱离,但许多作者都报道了其晚期并发症。因此,进行硅油取出术(SOR)以减少这些并发症。对连续63例病例进行了硅油取出术的研究。所有这些眼睛在进行硅油取出术前视网膜已完全复位至少3个月,没有牵引或再增殖的迹象,且最低视力为4/200。13只眼的硅油填充时间少于6个月,18只眼为6至12个月,32只眼超过1年。在创伤后和糖尿病病例中,8至10个月后可取出硅油,在增生性玻璃体视网膜病变(PVR)病例中14个月后可取出。视网膜再脱离是硅油取出术最常见的并发症,在63只眼中有18只出现;其中16只进行了再次填充。9只眼中恢复了硅油取出术前的视力。PVR、糖尿病和创伤病例的再脱离率相似,且与硅油填充时间无关。13只眼在硅油取出术前观察到眼压升高,但8例未经进一步手术随后眼压恢复到正常水平。我们的研究结果表明,即使非常谨慎地确定手术指征,硅油取出术仍会导致相对较高的并发症发生率,如视网膜再脱离。因此,每例接受该手术的病例都必须进行详细评估。