硅油充填眼行白内障超声乳化人工晶状体植入联合硅油取出术

目的 探讨玻璃体切割术后硅油充填眼经透明角膜切口行白内障超声乳化摘除、硅油取出、人工晶状体植入联合手术(1组)以及经睫状体平坦部置灌注管行白内障超声乳化摘除、硅油取出、人工晶状体植人(2组)两种手术方式的临床疗效观察。方法 对2000年1月～2003年4月间玻璃体切割术后硅油充填眼白内障患者78例(78只眼)经透明角膜行联合手术。对49例(49只眼)经睫状体平坦部行联合手术。观察眼底视网膜复位良好，行人工晶状体植入术。结果 1组病例有中52只眼最佳矫正视力达0.1～0.6(66．67％)；19只眼视力为0.02～0.1(24．36％)；7只眼视力为光感～指数(8．97％，包括5只眼视网膜脱离复发者)。2组病例中31只眼最佳矫正视力达0.1～0.6(65．3％)；11只眼视力为0.02～0.1(22．45％)；7只眼视力为光感～指数(14．3％，包括2只眼视网膜脱离复发者)。2组病例中有1只眼出现睫状体平坦部切口渗血，所有病例均无持续性角膜内皮失代偿、硅油泡残留、人工晶状体移位等并发症发生。结论 硅油眼行白内障超声乳化、硅油取出、人工晶状体植入术对于玻璃体切除手术后硅油充填眼并发白内障是一种安全、有效的方法。经透明角膜切口行此手术简化了手术步骤，减少了手术并发症的发生。     

睫状体平坦部硅油取出联合后囊膜切开术临床观察

目的 探讨睫状体平坦部硅油取出联合后囊膜切开术的临床效果.方法 对2008年1月至2010年1月间48例(48只眼)玻璃体切割联合硅油注入眼并发后发障患者行睫状体平坦部硅油取出联合后囊膜切开术.结果 术后矫正视力提高34只眼(70.8％).出现3例(6.3％)持续性低眼压、1例(2.1％)玻璃体腔少量血性混浊,所有病例均无大性角膜病变、硅油泡残留、人工晶状体移位或损伤、玻璃体积血等并发症.结论 经睫状体平坦部硅油取出术联合后囊膜切开术对玻璃体切除手术后硅油充填眼并发后发障是一种安全、便捷有效的手术方式.     

硅油取出联合白内障超声乳化及人工晶状体植入术疗效观察

目的探讨硅油充填眼术后并发性白内障行白内障超声乳化及人工晶体植入联合硅油取出术的临床效果。方法对19例(19只眼)硅油填充术后并发性白内障患者进行经睫状体扁平部切口取硅油联合白内障超声乳化及人工晶状体植入术。结果术后随访3-12个月(平均7个月)。手术后最佳矫正视力光感～眼前指数2只眼,0.02～0.1者4只眼,0.1～0.2者8只眼,0.2以上5只眼。1眼因视网膜脱离复发,经再次手术硅油充填后视网膜复位。1眼术后玻璃体出血,经药物治疗后出血吸收。所有患者均无角膜内皮失代偿、人工晶体移位、硅油残留等。结论硅油取出联合白内障超声乳化及人工晶状体植入术是安全、有效的。严把联合手术的适应症及具备相当的手术技巧是手术成功的关键所在。     

硅油填充眼的白内障超声乳化联合硅油取出术

目的：探讨玻璃体视网膜手术联合硅油眼内填充术后并发性白内障行白内障超声乳化和/或人工晶体植入联合硅油取出术的临床效果。方法：对22例22眼硅油填充术后并发性白内障进行白内障超声乳化联合硅油取出手术,其中9例通过巩膜隧道切口植入硬性人工晶体,3例通过角膜切口植入折叠人工晶体,10例未植入人工晶体。结果：22例手术中后囊膜保持完整,除10例因高度近视、视网膜条件很差或再发视网膜脱离而未植入人工晶体外,蓁均顺利植入人工晶体。术后5例发生角膜水肿,均在术后3～7天内消退。硅油取出顺利。3例术中发现限局性网脱,行视网膜复位后,2例C2F6气体填充后2周再发网脱,1例再次硅油填充视网膜保持复位。视力除3例再发网脱外,其余均达到玻璃体手术后最佳视力。结论：硅油填充眼合并白内障行白内障超声乳化联合硅油取出手术不仅安全、有效、而且可减少病人多次手术的痛苦。     

硅油填充眼并发性白内障手术探讨

目的探讨硅油充填眼术后并发性白内障行超声乳化联合硅油取出及人工晶状体植入术的临床效果。方法对26例（26眼）硅油填充术后并发性白内障进行超声乳化经睫状体平坦部切口取硅油联合折叠式人工晶状体植入术。术后随访4-15个月（平均8个月）。结果手术后最佳矫正视力：光感-眼前数指者2眼,0.02-0.1者5眼,〉0.1-0.2者11眼,≥0.3者8眼。1眼因视网膜脱离复发,经再次手术硅油充填后视网膜复位。所有患者均无角膜内皮失代偿、人工晶状体移位或硅油残留等。结论硅油填充眼合并白内障行超声乳化联合硅油取出及折叠式人工晶状体植入术能有效提高视力,减少手术次数,提高手术安全性。     

经角膜切口行白内障超声乳化联合硅油取出术临床观察

在玻璃体切割术后硅油充填眼中,并发性白内障是最常见的手术并发症。我院对2006年1月至2010年4月间玻璃体切割术后硅油充填眼白内障患者36例（36只眼）经透明角膜切口行白内障超声乳化、硅油取出、人工晶状体植入联合手术。一、资料与方法1.一般资料：采用经透明角膜切口行此联合手术36例     

硅油充填眼并发性白内障超乳、人工晶体植入联合硅油取出疗效观察

目的：评价玻璃体切除术硅油充填眼并发性白内障超声乳化摘除,人工晶体填入及硅油取出联合手术的临床疗效。方法：对玻璃体切除术硅油充填眼并发性白内障２０例（２０眼）施行该联合手术,术中采用颞侧巩膜双通道分别用于固定灌注针及供光源进入眼内用,分割碎核法囊袋内超声乳化晶体核后,用撕囊镊连续环形撕开晶体后囊膜,使硅油通过晶体后囊切口、瞳孔、角巩膜切口排出,观察眼底视网膜无特殊情况后,植入人工晶体于囊袋内。结果：除１例术后１４天出现视网膜脱离视力较差外,其余１９例术后视力均有不同程度提高,其中１２例术后最佳矫正视力０．１～０．８（６０％）。７例术后视力为０．０５～０．１（３５％）;另１例术后视力眼前手动。术后主要并发症为视风膜脱离,未见玻璃体腔出血、持续性角膜内皮失代偿、黄斑囊样水肿、硅油残留、晶体移位等。结论：该联合手术对     

孤眼视网膜脱离患者玻璃体视网膜手术体会

目的探讨孤眼（另一眼已肓,且视力无法恢复者）复杂性视网膜脱离患者行玻璃体视网膜手术,寻求最大限度地保留患者视力的方法。方法对2008年1月～2009年2月我科行手术的孤眼复杂性视网膜脱离20例进行回顾性分析,总结手术方法的选择,术后视力、眼压以及硅油的存留和取出情况。手术均采用经睫状体平坦部三通道玻璃体切除,术中行剥膜、气-液交换、冷凝（或光凝）和硅油填充术。结果术后随访1月～1年,矫正视力≥0．3者7例;0．1～0．25者9例;〈0．1者4例。因继发青光眼或硅油乳化行部分硅油取出10例（50．00％）,术后眼压控制在21mmHg以下14例,22～25mmHg3例,26mmHg及以上3例。硅油取出及联合白内障囊外摘出人丁晶体植入13例,最佳矫正视力0．08—0．6;保留硅油7例（35．00％）,最佳矫正视力为光感-0．15。术后并发白内障者3例,硅油乳化7例,角膜变性2例（年龄均小于20岁）。结论对于孤眼视网膜脱离患者,玻璃体手术较其他手术视网膜复位成功率高,因玻璃体浑浊牵拉导致视网膜脱离的复发率低,且可以使视网膜达到复位,有效提高术后视力。加强随访,控制眼压,减少并发症,尽早取出硅油,适当放宽硅油保留时间,最大限度地保留术眼有用视力,对提高患者生活质量具有重要意义。     

硅油取出联合白内障摘除并人工晶状体植入术的临床分析

目的：对硅油填充术后白内障手术结果进行总结分析。方法：行白内障囊外除联合人工晶状体植人及取出硅油。结果：经4～24mo随访,22例(22眼),视力2眼(9％)光感～指数;12眼(54％)≥0．1;6眼(27％)达到≥0．3;1眼(5％)最佳矫正视力达1．0;其中1眼(5％)出现视网膜脱离复发,经再次硅油充填后视网膜复位。结论：硅油填充术后的白内障囊外除联合人工晶状体植入术与同时取出硅油是一种较理想的方法。     

硅油填充眼并发白内障的手术治疗

目的探讨小切口非超乳白内障摘出,经睫状体平坦部硅油取出联合人工晶状体植入治疗硅油填充眼并发白内障的疗效。方法对16例（16眼）进行小切口非超乳的白内障摘出,经睫状体平坦部硅油取出,人工晶状体植入联合手术。术后随访1年,观察术后视力、视网膜情况及并发症。结果术后随访56．25％（9／16）视力提高明显,1例出现视网膜脱离,所有患者无人工晶状体移位等特殊并发症。晶状体前后囊有不同程度浑浊,中央部因无囊组织而透明。结论该联合手术治疗硅油眼并发白内障安全有效的方法,同时降低医疗成本,减少患者多次手术造成的痛苦; 严格掌握手术适应证、选择合适病例和具备娴熟技巧是手术成功的关键。     

Physical properties of vitamin E oil and silicone oil

A comparison of the physical properties of vitamin E oil and silicone oil is made. The parameters measured include: viscosity, fluid density, refractive index and wetting characteristics of the water/liquid interface. These properties showed remarkable similarities between vitamin E oil and silicone oil.     

硅油填充术后前房硅油分析

目的：评估硅油填充术后前房硅油及其对眼压的影响。方法：对110例112眼行硅油填充术的患者的临床资料进行回顾性分析。结果：术后1－21月随访发现19眼（17％）前房硅油,其中16眼（84％）为无晶体眼：12眼下方6点虹膜周切闭锁,4眼周切大于2mm。前房硅油中继发青光眼的发生率为53％（10／19）,角膜混浊21％（4／19）。结论：虹膜周发闭锁为无晶体眼中硅油入前房的首要原因。前房硅油继发性青光眼发生率率,应予及早取出。     

Central scotoma associated with intraocular silicone oil tamponade develops before oil removal

Background Unexplained sudden visual loss after removal of silicone oil from the eye has recently been described. We report the occurrence and features of unexplained central scotoma developing with silicone oil in situ in the vitreous cavity. Methods A retrospective case series of five patients (from two centres) who reported a central scotoma commencing during silicone oil tamponade was studied. All patients had vitrectomy for macula-on retinal detachment, with ultra-purified silicone oil tamponade (four out of five had giant retinal tear). Investigations included visual acuity, intraocular pressure, optical coherence tomography, fluorescein angiography, visual fields and electrophysiology. Results All patients reported a central scotoma that appeared during oil tamponade. Visual acuity fell by a mean of 0.93 LogMAR units after onset of the scotoma. After cataract extraction and oil removal, vision remained reduced by a mean of 0.8 units. The mean duration of oil in the eye was 2.7 months when the scotoma was noted by the patient. Investigations were performed after removal of oil. Fluorescein angiography (FFA) was performed in two cases and optical coherence tomography (OCT) in five patients. No abnormality was demonstrated. Electrophysiology was performed in five patients with pattern electroretinography suggestive of macular dysfunction in four patients. Conclusion This is the first case series describing central scotoma associated with silicone oil in situ. Electrophysiology indicated macular dysfunction in most cases. We suggest that early removal of oil in cases with good visual potential should be considered to avoid this sight-threatening complication. Presented in part at Britain and Eire Association of Vitreo-Retinal Surgeons, November 2003.     

Silicone oil and fluorosilicone

Silicone oil has been used to fill the vitreous cavity for long-term or permanent internal tamponade in eyes with proliferative vitreoretinopathy or complicated retinal detachment due to ocular trauma, giant retinal tears, proliferative diabetic retinopathy, and cytomegalovirus retinitis. Reports from the Silicone Study confirmed its efficacy in the treatment of proliferative vitreoretinopathy and addressed outcome differences in vitrectomized and nonvitrectomized eyes, combined retinotomy, silicone oil removal, and complications associated with silicone oil tamponade, such as intraocular pressure abnormalities and corneal abnormalities. Because silicone oil is lighter than water and not adequate in supporting the inferior quadrants, several heavier-than-water materials have been introduced for intraocular tamponade. Silicone oil can be a potential vehicle for delivering antiproliferative agents to treat proliferative vitreoretinopathy.