重硅油玻璃体腔充填治疗复杂性视网膜脱离的临床研究

目的 评价重硅油作为眼内填充剂治疗复杂性视网膜脱离的有效性和安全性.方法 采用标准的玻璃体切割联合重硅油Oxane HD充填术治疗复杂性视网膜脱离患者13例13只眼,术中根据病情联合白内障摘除、巩膜环扎、增殖膜剥除、视网膜切开、重水压平视网膜行眼内激光光凝等.观察重硅油充填期及取出后术眼的最佳矫正视力、视网膜解剖复位情况、手术后并发症等.结果 重硅油充填期平均为93d,取出后平均随访170d.13只眼中有12只眼最佳矫正视力提高,1只眼视力无改善.有10只眼在眼内充填重硅油至取出后保持稳定的视网膜复位至随访结束.术后主要并发症包括轻至中度的眼压升高、眼前段炎症反应、晶状体混浊、增殖膜形成和硅油乳化等.结论 重硅油Oxane HD作为眼内填充物可以有效安全地治疗复杂性视网膜脱离,尤其是伴下方或后极部裂孔的视网膜脱离.

A clinical study on heavy silicone oil in the treatment of complicated retinal detachment

Objective To evaluate the therapeutic effect and safety of heavy silicone oil used as interhal tamponade to treat complicated retinal detachment. Methods Vitreoretinal surgery and intraocular tamponade of heavy silicone oil (Oxane HD) were used in 13 patients (13 eyes) with complicated retina detachment. Scleral buckling, epiretinal membrane peeling, retinotomy, per-fluorocarbon liquid infusion, laser photocoagulation, phacoemulsification were performed in some patients. The best-spectacle corrected visual acuity (BCVA), retinal status and complications after surgery were observed. Results The mean duration of heavy silicone oil endotamponade was 93 days and the mean follow-up was 130 days after heavy silicone oil removal. BCVA was improved in 12 cases (92.3%). Retinal reattached and holes were closed in 10 cases with heavy silicone oil endotamponade (77%) in the end of the follow-up. The postoperative complications included moderate high intraocular pressure, temporary inflammatory reaction, lens opacity, fibrocellular membranes proliferation and heavy silicone oil emulsification. Conclusions The heavy silicone oil Oxane HD is effective and safe to treat complicated retinal detachment, especially with holes located in the inferior and posterior pole.