硅油眼的硅油取出联合白内障超声乳化术的疗效观察

目的观察玻璃体切除术后硅油填充眼患者硅油取出联合超声乳化人工晶状体植入术的术后视力、屈光度变化和术中及术后并发症情况。方法收集17例(17眼)玻璃体切除术后硅油填充眼的白内障患者,行硅油取出联合超声乳化人工晶状体植入术,观察术前及术后最佳矫正视力(BCVA)、眼压,术中及术后并发症情况,并对术后实际屈光度和术前目标屈光度进行比较。结果随访时间为3～14.5个月,平均(4.00±2.81)个月。6眼术后BCVA为0.05～0.1,6眼为0.12～0.3,4眼为0.4～0.7,1眼>0.8。术后眼压为(13.61±3.67)mm Hg(1mm Hg=0.133kPa),与术前(16.31±6.95)mm Hg相比,差异无统计学意义(Z=1.1043,P=0.2933)。术后实际测得屈光度为(-1.09±3.91)D,与术前目标屈光度(-1.46±1.29)D相比,差异无统计学意义(Z=3.7504,P=0.0527)。术中1眼出现灌注偏离综合征,9眼行中央部后囊膜切除,所有患者术中未出现晶状体坠入玻璃体腔等并发症。术后早期5眼出现轻度角膜水肿,1眼行掺钕钇铝石榴石(Nd:YAG)激光后囊膜切开,2眼发生视网膜再次脱离。结论玻璃体切除硅油填充患者行硅油取出联合超声乳化人工晶状体植入术可有效提高视力,术后实际屈光度与术前目标屈光度较为一致,手术并发症少,手术方法安全、有效。

Therapeutic effect of silicone oil removal combined with phacoemulsification in vitrectomized eyes

Objective To evaluate the changes of visual acuity, refraction,intraoperative and postoperative complications of silicone oil removal combined with phaeoemulsification and intraocular lens implantation in silicone oil tamponade vitrectomized eyes. Methods The study included 17 patients （ 17 eyes） with cataract and silicone oil tamponade after pars plana vitrectomy. The patients were treated with silicone oil removal combined with phaeoemulsifieation and intraocular lens implantation. Best corrected visual acuity （BCVA）, intraocular pressure （IOP） and intraoperative and postoperative complications were recorded. The actual postoperative refraction was compared with the predicted refraction from preoperative data. Results The mean period of follow-up was （4.00 ± 2.81 ） months. After surgery, BCVA was 0.05 -0.1 in 6 eyes, 0. 12 - 0.3 in 6 eyes, 0.4 - 0.7 in 4 eyes, and 0.8 - 1.0 in one eye. The mean IOP was （13.61 ± 3.67） mm Hg, which didn＇t have significant difference from the mean preoperative IOP （16.31 ± 6.95 ）mm Hg （Z = 1. 104 3, P = 0.293 3）. And the mean actual postoperative refraction was （ -1.09 ± 3.91 ） D, which also didn＇t have significant difference from the preoperative predicted refractions （ -1.46 ± 1.29） D （ Z = 3. 750 4, P = 0.052 7 ）. One eye had infusion deviation syndrome and 9 eyes obtained PCCC. None eyes had the crisp of the lens dropping into vitreous cavity in the procedures of the surgery. In the early period after the surgery, 5 eyes had mild corneal edema, 1 eye had posterior capsule opacification and 2 eyes had retinal redetachment. Conclusions Silicone oil removal combined with phacoemulsification and intraocular lens implantation was able to improve patients＇ visual acuity. There was no significant difference between actual postoperative refraction and the predicted refraction. The approach was safe and effective for the eyes with cataract and silicone oil tamponade after pars plana vitrectomy. （Chin J Ophthalmol and Otorhinolaryngal, 2012,12 ： 296 -300 ）