硅油取出术后视网膜再脱离的危险因素分析

目的：探讨硅油取出术后视网膜脱离复发的危险因素。

方法：我们对2008-01/2011-10所有在本中心眼底病小组行硅油取出的125例128眼患者进行回顾分析性研究，所有眼在之前均由于各种原因导致视网膜脱离而在我中心行玻璃体切除加硅油填充术。我们采用二元逻辑性回归对硅油取出术后视网膜再脱离的可能相关危险因素进行分析，包括性别、年龄、原发病的诊断、硅油取出术前的晶状体状态、硅油在眼内存留时间、硅油取出术前所进行的眼后节手术操作次数、是否做过巩膜外环扎、玻璃体切割的手术方式(20G或23G)、行硅油取出术时是否同时进行眼前段或视网膜的手术操作。

结果：在所有行硅油取出术的128眼中有23眼(18.0%)发生复发性视网膜脱离，硅油取出术前眼后节手术的次数和原发病的诊断类型是视网膜脱离复发的独立相关危险因素。硅油在眼内的存留时间与硅油取出术前眼压升高(IOP≥25mmHg)存在正相关。

结论：硅油取出术后存在较高的视网膜脱离复发的风险，尤其是严重的眼外伤导致的视网膜脱离以及之前反复手术的患者。

Risk factor analysis on recurrent retinal detachment after silicone oil removal

AIM:To find the risk factors for recurrent retinal detachment after silicone oil removal.METHODS:We retrospectively reviewed all silicone oil removed surgeries performed between January 2008 and October 2011 in our vitreous-retinal group.All eyes had pars plana vitrectomy and silicone oil tamponade before in our center caused by retinal detachment.Binary logistic regression was used to find out the risk factors associated with recurrent retinal detachment.Factors analyzed included gender,age,primary diagnosis,lens state before silicone oil removal,duration of silicone oil,times of posterior segment surgeries,whether circling buckle was used,whether 20-gauge or 23-gauge vitrectomy was used,if combined with anterior segment surgeries during silicone oil removal,if combined with anterior segment or retinal operations during silicone oil removal.RESULTS:Altogether,128 eyes were collected,and 23 eyes(18.0%) had recurrent retinal detachment.Times of posterior segment surgeries before silicone oil removal and primary diagnosis were the independent risk factors associated with recurrent retinal detachment.The duration of silicone oil had a positive correlation with intraocular pressure elevation(IOP≥25mmHg).CONCLUSION:Recurrent retinal detachment is a relatively frequent complication after silicone oil removal,especially for eyes with serious ocular trauma and multiple posterior segment surgeries.