硅油取出后视网膜脱离复发危险因素分析

目的探讨硅油取出术后视网膜脱离复发的主要危险因素。方法回顾分析重庆医科大学第二附属医院眼科2005年1月至2007年6月行硅油取出术的病例共143眼，对疾病原因、硅油在眼内存在的时间、硅油取出后有无眼底出血以及第一次玻璃体切割手术后患眼玻璃体残留皮质的情况进行统计学分析。结果硅油取出后视网膜脱离复发的病例40眼，增殖性玻璃体视网膜病变的再脱率与糖尿病视网膜病变的视网膜再脱离率比较χ^2=5.02，P〈0．05；复发病例中发生眼底出血比例与未复发病例中发生眼底出血比例的比较，P〈0．05，视网膜脱离复发的病例中有残留玻璃体皮质比例与未脱离的病例中有残留玻璃体皮质比例的比较，P〈0．05，复发病例中硅油眼内填充的平均时间与未复发病例硅油眼内填充的平均时间相比，P〉0．05。结论硅油取出后视网膜脱离的危险因素主要是增殖性玻璃体视网膜病变、手术后有残留的玻璃体皮质、术后眼底出血的发生，这些因素直接导致了玻璃体的增殖，牵拉形成新裂孔。引起视网膜脱离的复发。

Risk factors for retinal redetachment after removal of intraocular silicone oil tamponade

Objective To explore the main risk factor for retinal redetachment after removal of intraocular silicone oil tamponade. Methods Retrospective analysis was performed on the clinical data of 143 eyes undergoing intraocular silicone oil removal in our department from January 2005 to June 2007. The etiopathogenisis, detention time of silicon oil in eyes, subhyaloid hemo/rhage status after removal of silicone oil, and corpus vitreum cortex detention after the first vitrectomy were statistically analyzed. Results Detachment of retina recurred in 40 suffered eyes afer removal of silicone oil. There were statistical differences in redetaehment rate between proliferative vitreoretinopathy group and diabetic retinopathy group （χ^2=5.02, P〈0.05） ; in incidence of subhyaloid hemorrhage and retention rate of corpus vitreum cortex between recurrence group and non-recurrence group （both P〈0.05） ; whereas there was no significant difference in average detention time of silicon oil in eyes between recurrence group and non-recurrence group （P〉0.05）. Conclusion The risk factors for recurrent detachment after removal of silicone oil are as follow- ing：proliferate vitreoretinopathy, postoperative corpus vitreum cortex detention and subhyaloid hemorrhage, which lead to recurrence of ablatio retinae directly by means of corpus vitreum proliferating,hauling and formation of new hiatus.