自闭式巩膜隧道切口在有晶状体眼硅油取出术中的应用观察

目的 硅油作为眼内充填物治疗复杂性视网膜脱离，硅油在手术后一段时间内要取出以减少长期眼内硅油存在可能引起的并发症，本文介绍一种有晶状体眼的自闭式巩膜隧道灌注口硅油取出方法。方法37只有晶状体硅油眼接受自闭式巩膜隧道灌注口的硅油取出，记录术毕时切口的渗漏情况，术后观察视力、眼压、视网膜再脱离及其它并发症。随访3～6个月。结果 术中同时进行晶状体摘除5例，晶状体摘除联合人工晶状体植入8例，术毕时有4只眼切口有轻度渗漏，需要补充缝线，随访视网膜在位34眼(91．9％)，视力提高或不变29眼(78．4％)。结论 拔除灌注管后迅速有效地封闭切口是硅油取出术的一个重要手术技巧，应用自闭式巩膜切口作为灌注口，可以防止拔管后切口的渗漏，有效地维持眼压，对减少硅油取出术后的视网膜再次脱离有一定作用。

Self- sealing sclera tunnel incision for silicone oil removal

Objective Combined with vitreoretinal surgery,silicone oil injection has become a standard technique and improves the prognosis of complex retinal detachment.As silicone oil leads to long term complications,removal of silicone oil from the eye is recommended.Here we introduce a method of silicone oil removal using a self-sealing sclera tunnel incision to insert the infusion cannula.Methods 37 cases of silicone oil removal(37 eyes)were underwent self-sealing sclera tunnel incision.To evaluate the outcome after silicone oil removal,leakage of fluid,retinal redetachment,visual acuity,and complications were analyzed.Results Cataract extractions were performed in 13 eyes,and in 8 of these cases underwent implantation of a posterior chamber lens.Distortions of scleral flap incisions were resutured in 4 eyes because of minimal loss of intraocular fluids.Anatomic success after silicone oil removal,defined as a complete retinal attachment,was achieved in 34 of 37 eyes(91.9%).Visual acuity improved or remained unchanged in 29 eyes(78.4%).Conclusions After completion of the silicone oil removal,closure sclerotomy and maintenance of intraocular pressure after removal of the infusion cannula can be particularly troublesome.Self-sealing sclera tunnel incision could effectively reduce the risk of postoperative hypotony and fluid leakage following removal of the infusion cannula,and decrease the rate of redetacment of retina.