硅油取出术59例临床观察分析

目的:探讨硅油取出术临床应用对硅油填充及硅油取出的并发症、视网膜恢复情况及取油时机。方法:在显微镜下通过巩膜切口主动持续负压抽吸硅油。结果:患者59例62眼硅油填充眼取出硅油后,53眼视网膜复位,9眼视网膜未完全解剖复位,需进一步手术干预。结论:在视网膜复位3～6mo后,可行硅油取出术,可减轻硅油对眼的毒副作用及减少并发症,减少硅油取出术并发症,极少数为硅油依赖眼。     

眼内硅油取出术及并发症的临床探讨

目的 探讨眼内硅油取出的时机、取出方法、并发症及其危险因素。方法 ４２例（４２只眼）睫状体扁平部作切口,应用玻璃体切割机负压吸引行眼内硅油取出术,取出时间平均为硅油注入术后５．７个月。结果 硅油取出术后视力提高１３例（３１％）,视力不变２２例（５２％）,视力下降７例（１７％）。术后视网膜在位３７例,３例分别于硅油取出术后第５天、第８天及第２０天视网膜脱离复发。术后发生低眼压１例（≤５ｍｍＨｇ）。４     

两种硅油取出术并发症分析

目的:比较常规扁平部三通道硅油取出术和既往两切口单纯硅油取出术的手术并发症,考察并评价其临床效果。方法:回顾性分析2001-04/2003-06以及2003-06/2006-11两个时期(分为两组)在本院行硅油取出术的临床连续病例。前组共78例(78眼),47例无晶状体眼采用角膜缘或角膜小切口取出硅油;7例有晶状体眼采用睫状体平坦部双切口取硅油;16例联合白内障手术者,常规行超声乳化或ECCE术,再撕开后囊膜,从前房白内障手术切口放出硅油;8例视网膜复位欠佳,或局部有增生膜者,硅油取出联合常规三通道玻璃体切除术。后组病例共113例(113眼),不论有无晶状体,全部病例均采用常规扁平部三通道取硅油,取油时联合切除残余玻璃体基底部、视网膜光凝及剥离视网膜前膜。硅油取出术后随访5mo～5a,平均随访时间为(2.7±2.1)a。结果:前组中共有3例发生脉络膜上腔出血(3.8%);15例发生视网膜再脱离(19.2%);8例眼压控制不良需加用降眼压药物(10.3%);12例出现低眼压(眼压<5mmHg)(15.4%);1例术后发生角膜内皮失代偿(1.3%);38眼视力提高2行以上(48.7%)。后组病例中未出现脉络膜上腔出血和新发角膜病变,11例发生视网膜再脱离(9.7%),与前组比较差异具有统计学意义(P<0.05)。7例眼压控制不良需加用降眼压药物(6.2%),15例出现低眼压(13.3%);58眼视力提高2行以上(51.3%)。结论:虽然两切口单纯硅油取出术方法简单,在几年前应用较为普遍,但术中不能做一些眼底的详细检查及适当处理;而常规扁平部三切口硅油取出可以联合玻璃体切割及膜剥离、激光光凝等操作,有助于保持视网膜复位和视功能提高,减少并发症的出现,具有广泛的临床应用价值。     

硅油取出术的临床观察

自70年代以来，由于玻璃体手术不断完善与发展，硅油限内填充已成为玻璃体手术的一个重要组成部分，它显著地提高了复杂性视网膜脱离的手术效果。随着硅油在临床上广泛应用，有关硅油的并发症也引起人们广泛注意，目前大多数作者认为在适当的时机取出硅油甚为必要。但也有人主张长期填充不需取出。我们对因各种原因取出硅油的24例（25眼）作回顾性分析如下。资料和方法1．一般资料：24例（25眼）均为复杂性视网膜脱离行闭合式玻璃体切割术，并注入法国或德国硅油。男性18例，女性6例，年龄6岁～52岁，平均43岁。24例患者均因为出现一种或一…     

硅油取出术31例

３１例（３２只眼）行硅油取出术，其取出时间平均为硅油注入术后１３．９个月。取出原因主要为白内障形成、青光眼、硅油乳化等，其中６只眼为视网膜复位稳定无并发症者。硅油取出后，２４只眼视膜在位；２４只眼视力≥０．０２；８只眼发生术后并发症，其中７只眼为复发性视网膜脱离，对硅油取出术的意义和时机进行了讨论。     

部分硅油取出术疗效探讨

目的评价部分硅油取出术治疗眼内硅油填充术后早期并发症的效果.方法对15例(15眼)曾行硅油部分取出术的病例进行回顾性分析.包括硅油异位入前房10眼;硅油过量引起难以控制的眼内压升高5眼.结果随访1～7月(平均3.7月).15眼视网膜解剖复位;眼内压正常;1眼角膜变性,2眼有晶状体眼,晶状体后囊混浊.结论对眼内硅油充填术后早期出现的硅油位置异常、难以控制的眼内压升高考虑为硅油过量时,及时行部分硅油取出术,能减少后期硅油所导致的一系列并发症.     

硅油取出术后高眼压的转归

目的:观察高眼压的硅油填充眼在硅油取出后眼压的控制情况。方法:观察我科2006-06/2007-03收住的42例(42眼)高眼压的硅油填充患者,记录患者的一般情况、原发病、有无晶状体、有无硅油乳化、硅油取出手术前后的眼压、眼底情况等,并对相关数据进行统计学处理。结果:硅油取出手术前后眼压的比较具有显著性差异(P<0.05),术后高眼压的控制率为57.1%。其中,有晶状体眼组和无晶状体眼组术后高眼压控制率的比较无显著性差异(P>0.05),而硅油乳化组和未乳化组的比较有显著性差异(P<0.05)。结论:硅油取出手术可以有效的治疗多于半数的高眼压的硅油填充眼。硅油未乳化者的疗效可能要优于已乳化者。     

硅油取出术

硅油作为限内充填物治疗复杂性机网膜脱离已相当普及，使部分其它方法难以治疗或估计治疗有困难的病例获得解剖复位和改善视力的效果，但眼前节并发症相当常见（如49～100％发生白内障，11～44％发生角膜病变，11～33％继发青光眼）[1]，长期充填在所难免。因此，硅油作为一种暂时性充填物的理论已被人们接受，早期取出可预防硅油井发症的发生。一、硅油取出的适应证和时机硅油取出的比例文献报告在20％～75％之间，平均约41％[2]。取出时机尚无定论，Mccuen认为视网膜复位维持3～6个月后应取出硅油[3]，Gonvers则认为视网膜复位后6～8周即…     

83例硅油取出时机及并发症的临床分析

目的 分析硅油充填的时间与视网膜复位的关系及硅油在眼内存留时间和硅油并发症产生的关系。方法 回顾分析83例(83只眼)行硅油取出术患者的临床资料及随访记录。结果 行硅油取出的时间为3～13个月，平均8个月。在无发生硅油相关的并发症的条件下，78例在取出硅油之后，视力无明显改变或稍有提高。角膜变性的病例，在硅油取出之后，其混浊情况无明显改变。11例青光眼在硅油取出之后眼压恢复正常者8例，5例在硅油取出之发生了复发性视网膜脱离。结论 硅油取出的最佳时机是3～6个月。硅油取出可以缓解硅油并发症的发展。硅油取出术的并发症主要为复发性视网膜脱离、脉络膜出血、脉络膜脱离、视网膜出血及低眼压。     

硅油填充眼硅油取出术后高眼压的临床研究

目的探讨硅油取出术后高眼压的原因及处理方法。方法2011年12月到2013年6月本院硅油填充眼93例（93只眼）,根据硅油取出术前眼压分为正常眼压组及青光眼组两组,观察各组硅油取出气体C,F。填充术后眼压变化,进行总结、分析,讨论术后高眼压的原因。结果正常眼压组硅油取出术后1周及2周的眼压,较硅油取出术前高,差异有统计学意义（P〈0．05）;而术后1个月、3个月及6个月眼压与硅油取出术前相比,其差异无统计学意义（P〉0．05）。而青光眼组硅油取出术后1周、2周、1个月、3个月及6个月眼压虽较硅油取出术前低,（P〈0．05）,但大多仍高于正常值,硅油取出术后高眼压者在正常眼压组占21．6％（11／51）,在青光眼组占54．8％（23／42）。结论硅油取出术后高眼压是术后常见并发症,故术后监测眼压是必要的,以便及时发现,运用降眼压药物或联合手术进行治疗。     

PVR recurrence and the timing of silicon oil removal

BACKGROUND: Following vitrectomy for PVR-associated retinal detachment, placement of an encircling band, filling with silicone oil (SO) and successful retinal reattachment, a recurrence of PVR can develop. Retinal redetachment after SO removal is usually due to secondary or residual PVR. We wanted to ascertain whether the anatomical and functional outcomes of surgery in patients with a reattached retina and recurrent PVR can be improved by delaying the removal of SO. PATIENTS AND METHODS: 112 consecutive patients with PVR-associated retinal detachment who had undergone vitrectomy with SO filling, were monitored for at least 6 months after SO removal. Prior to SO removal, the retina posterior to the encircling band had to be completely reattached. Patients who developed PVR after SO filling were divided into two groups according to the duration of SO retention: 12 - 18 months (group 2: n = 48); > 18 months (group 3: n = 21). Individuals without PVR recurrence after SO filling and in whom the SO was consequently removed within 4 - 12 months served as control (group 1: n = 43). Anatomical success, intraocular pressure (IOP) and best-corrected visual acuity (BCVA) served as the primary clinical outcome parameters. RESULTS: Six months after SO removal, the anatomical success rates (86.3 %, 88.8 % and 84.6 %, in groups 1, 2 and 3, respectively; log rank = 0.794) and the BCVAs (p = 0.861) were comparable in the three groups. Mean IOP (p = 0.766), and the frequency of complications such as PVR recurrence (p = 0.936), bullous keratopathy (p = 0.981) and macular pucker (p = 0.943) were likewise similar. Patients in whom SO was retained for more than 18 months had the highest IOPs and required the heaviest dosage with anti-glaucoma drugs. CONCLUSIONS: In patients who develop a recurrence of PVR after vitrectomy and SO filling the surgeon can observe and treat retinal changes for up to 18 months without impairing the anatomical and functional outcomes. The retention of SO for more than 18 months does not improve the anatomical outcome. However, it can impair the functional outcome by precipitating the development of a persisting secondary glaucoma.     

硅油填充术后视网膜再脱离临床分析

目的:探讨玻璃体切除联合硅油填充治疗复杂性视网膜脱离术后 ,硅油填充期间发生视网膜再脱离的原因及处理方法。方法 :回顾总结分析 2 8眼硅油填充期间发生视网膜再脱离的原因 ,对不同眼底表现分别采取巩膜外顶压联合眼外激光封孔 ,硅油取出、剥膜、再次眼内填充 ,硅油下视网膜剪开等术式 ,观察治疗效果。结果 :2 8眼有 2 5眼解剖复位 ,3眼复位后再脱离 ,成功率为 89 3%。其中一次手术成功率 78 6 %。结论 :术后增殖膜形成牵引是硅油填充期间视网膜再脱离的主要原因 ,对不同类型的视网膜再脱离 ,应采取不同治疗措施     

28例取硅油病例的临床研究

２８例行硅油注入病例，由于硅油并发症的出现，行硅油取出术，平均取出时间为１１．８个月，其中有８只眼在硅油注入后视网膜再次脱离，有５只眼在取硅油时出现网脱，这些病例行再次视网膜复位术。另外１５只眼行单纯硅油取出术。本文对硅油注入后的并发症，硅油注入后复发视网膜脱离的原因以及硅油取出的时机和意义进行了讨论。     

自制硅油取出器的临床应用分析

目的 观察应用自制硅油取出器行硅油取出手术的临床效果.方法 利用自行设计并制作的硅油取出器,为45例(45只眼)硅油填充的患者行硅油取出术,术中记录患者硅油取出时间,观察术中及术后并发症的发生情况,并随访观察6个月以上.结果 所有患者均一次完成硅油取出,平均时间13 min,术中未出现脉络膜上腔出血、视网膜脱离等严重并发症.45例患者术后1周视力提高者20例;4只眼出现低眼压但均在2周内恢复正常;13例继发性青光眼的患者术后7只眼眼压恢复正常.所有患者术后未出现感染、脉络膜上腔出血、视网膜嵌顿及硅油残留等严重并发症.3只眼术后发生视网膜脱离.结论 该种硅油取出器设计简单实用,临床操作简便、安全.     

Silicone oil removal. I. The effect on the complications of silicone oil.

The results of a retrospective study of the effects of silicone oil removal from 85 eyes in 85 patients are reported. Pars plana vitrectomy and fluid/silicone oil exchange had been undertaken for retinal detachments associated with giant retinal tears or with proliferative vitreoretinopathy in all cases. Clinically significant cataract developed in 60% of lenses that were clear at the time of oil removal, and 85% of pre-existing lens opacities progressed. Removal of oil from 19 eyes with uncontrollable glaucoma was combined with drainage surgery in 14 eyes. Postoperatively the intraocular pressure was controlled in 13. Corneal decompensation either improved or was unchanged in eight out of nine patients after silicone oil removal, and three patients had penetrating keratoplasty and maintained a clear corneal graft. Patients who did not have glaucoma or keratopathy at the time of silicone oil removal did not develop these complications.     

Outcomes of combined phacoemulsification/intraocular lens implantation and silicon oil removal

International Ophthalmology - To evaluate the outcomes and complications of simultaneous silicon oil removal (SOR) and phacoemulsification and intra ocular lens implantation. In this retrospective...     

硅油取出联合白内障超声乳化术的临床探讨

目的 评估通过透明角膜切口完成白内障超声乳化及折叠式人工晶体植入联合经瞳孔前路硅油取出改良术的安全性及有效性。方法 对57例硅油充填眼完成白内障超声乳化后经瞳孔前路硅油取出联合折叠式人工晶体植入。结果 术后未发生明显角膜并发症,89.4%的病人（51例）未发生视网膜再脱离,复发性视网膜脱离6例（11.6%）,再次手术后成功复位。41例患者的术后视力改善。结论 白内障超声乳化及折叠式人工晶体植入联合硅油奴出改良术安全有效,可以最大限度地减少手术损伤。     

Silicone oil removal. II. Operative and postoperative complications.

A retrospective study of the effects of silicone oil removal was carried out on 85 patients who had undergone pars plana vitrectomy and silicone oil exchange for giant retinal tears or proliferative vitreoretinopathy. Silicone oil was removed either as part of the treatment of anterior segment complications such as glaucoma and keratopathy (25 patients) or in order to prevent these complications (60 patients). The major complications of the removal of silicone oil were retinal redetachment (25%), hypotony (16%), and expulsive haemorrhage (1%). The length of time that the oil remained in the eye and the presence of anterior segment complications did not appear to have an effect on the rate of retinal redetachment or hypotony.