硅油填充眼复发性视网膜脱离的手术治疗

目的:探讨硅油填充眼复发性视网膜脱离的原因、手术方法选择及临床疗效。方法:对29例29眼硅油填充眼复发性视网膜脱离的原因、手术方式、解剖复位和视功能恢复结果进行分析。结果:复发性视网膜脱离由增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)引起者15眼行硅油取出+剥膜+注气或硅油填充术;裂孔未封闭者行剥膜+硅油填充+光凝,其中周边裂孔8眼,黄斑裂孔2眼,巨大裂孔后瓣漏脱者2眼,7眼联合巩膜扣带(外加压);2眼行环扎巩膜扣带+外加压+外放液+冷凝;术后均获得解剖复位,视功能提高者15眼,随访4mo,6眼复发。结论:硅油填充眼视网膜脱离的原因是多种的,根据不同的眼底表现应该选择不同的手术方法。

Operation therapy for the treatment of recurrent retinal detachment in silicone oil-filled eyes

AIM:To explore causes,selection of technique and clinical curative effect of recurrent retinal detachment in silicone oil-filled eyes.·METHODS:The causes,modus operandi,anatomic reduction and visual functional recovery of recurrent retinal detachment in silicone oil-filled eyes of 29 cases(29 eyes) were analyzed.·RESULTS:Fifteen eyes with recurrent retinal detach-ment caused by PVR were managed with dislodgment of Silicone Oil,stripping of membrane and gas injection or Silicone Oil filling. Patients with unclosed breaks(8 eyes with peripheral unclosed breaks,2 eyes with unclosed macular hole,2 eyes with posterior slippage of giant retinal tear) underwent stripping of membrane,Silicone Oil filling and photo-coagulation,among which 7 eyes were managed with scleral huckling in addition,and 2 eyes underwent scleral huckling,extra-compression,extra-tapping and condensation. Anatomic reduction was obtained in all cases,and Visual acuily was improved in 15 eyes. 4 months after follow-up,recurrence was found in 6 eyes.·CONCLUSION:The causes of recurrent retinal detach-ment in silicone oil-filled eyes seems to be varietal,and operations should be chosen according to different eyeground manifestation.