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重硅油Densiron 68眼内填充治疗外伤性视网膜脱离的疗效与并发症
引用本文:李林,李琦琰,庞秀琴. 重硅油Densiron 68眼内填充治疗外伤性视网膜脱离的疗效与并发症[J]. 眼科, 2012, 21(4): 252-256
作者姓名:李林  李琦琰  庞秀琴
作者单位:100730.首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室
摘    要:【摘要】 目的 比较重硅油Densiron 68与普通硅油眼内填充治疗外伤性视网膜脱离的效果及并发症。设计 回顾性比较性病例系列。研究对象 北京同仁医院住院的外伤性视网膜脱离患者40例(40眼)。方法 患者均行标准睫状体平坦部玻璃体切除联合视网膜复位术。视网膜脱离及裂孔主要位于视网膜下方或后极部的20例患者应用Densiron 68填充,其他20例用普通硅油填充。术后随访12~68周。主要指标 视力、眼压、视网膜复位及并发症情况。结果 重硅油组和普通硅油组视网膜复位率分别为50%、55%(P=0.752)。上方视网膜脱离者未复位率,重硅油组60%(6/10),普通硅油组11%(1/9)(P=0.057);下方视网膜脱离未复位率,重硅油组10%(1/10),普通硅油组67%(6/9)(P=0.020)。重硅油组logMAR视力术前(2.63±1.00),术后(2.19±0.86)(P=0.037);普通硅油组logMAR视力术前(2.27±1.06),术后(1.74±1.04)(P=0.112)。重硅油组平均眼压术前(10.60±5.53) mmHg,术后(13.63±4.66)mmHg(P=0.040);普通硅油组术前(12.76±7.81) mmHg,术后(13.69±6.18)mmHg(P=0.652)。普通硅油组术后高眼压发生率30%,重硅油组0%(P=0.020)。重硅油组均发生了不同程度的硅油乳化,普通硅油组75%发生乳化(P=0.047)。结论 重硅油眼Densiron68眼内填充对裂孔及脱离主要位于下方的外伤性视网膜脱离效果较好;但其术后乳化率高于普通硅油,不适于长期眼内填充。(眼科,2012,21:252-256)

关 键 词:重硅油  视网膜脱离  眼外伤  
收稿时间:2011-12-21

Efficacy and complications of heavy silicone oil Densiron68 for traumatic retinal detachment
LI Lin , LI Qi-yan , PANG Xiu-qin. Efficacy and complications of heavy silicone oil Densiron68 for traumatic retinal detachment[J]. Ophthalmology in China, 2012, 21(4): 252-256
Authors:LI Lin    LI Qi-yan    PANG Xiu-qin
Affiliation:Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
Abstract:Objective To observe efficacy and complications of heavy silicone oil(HSO) Densiron68 for traumatic retinal detachment.Design Retrospective compare case series.Participants 40 eyes of 40 patients with traumatic retinal detachment in Beijing Tongren Hospital.Methods The pars plana vitrectomy and retinal detachment surgery were applied to the 40 patients.HSO was applied to 20 patients with retinal detachment arising from inferior or posterior retinal breaks(HSO group).Other 20 patients were applied with standard silicone oil(SSO group).The follow-up time was 12 to 68 weeks.Main Outcome Measures Visual acuity,intraocular pressure,retinal reattachment and complications.Results The retinal reattachment rate in HSO group was 50%(10/20) compared to 55%(11/20) in SSO group(P=0.752).The recurrent rate of superior retinal detachment was 60%(6/10) in HSO group,and 11%(1/9) in SSO group(P=0.057).The recurrent rate of inferior retinal detachment was 10%(1/10) in HSO group,and 67%(6/9) in SSO group(P=0.020).In HSO group,logMAR visual acuity improved from preoperative 2.63±1.00 to postoperative 2.19±0.86(P=0.037).In SSO group,logMAR visual acuity improved from preoperative 2.27±1.06 to postoperative 1.74±1.04(P=0.112).Significant increase of intraocular pressure occurred in 30% patients in SSO group while 0% in HSO group(P=0.020).Emulsification rate of silicone oil in SSO group was 75% compared to 100% in HSO group(P=0.047).Conclusion Heavy silicone oil Densiron 68 is applicable to traumatic retinal detachment with inferior or posterior retinal breaks.It is not advised to use heavy silicone oil for long term tamponade because of its higher emulsification rate compared with standard silicone oil.
Keywords:heavy silicon oil  retinal detachment  ocular trauma
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