眼内窥镜引导简化硅油取出的方法

目的 利用眼内窥镜的优点，探讨简化玻璃体腔硅油取出的方法。方法 回顾82例(97眼)内窥镜引导下的无晶状体眼或联合白内障摘除术的硅油取出术的病例，记录其手术时间和术中并发症，随访27～60个月，观察其术后1 d、1周、1个月、6个月的视力、眼压、角膜内皮细胞密度、视网膜脱离复发率、硅油残留率和其他并发症。结果 手术时间15.6～46.3 min,平均(20.6±8.3)min,术中未见明显并发症。术前最佳矫正视力(best corrected visual acuity, BCVA)为(2.04±0.58)LogMAR,术后1 d、1周、1个月、6个月的BCVA为(1.92±0.79)LogMAR、(0.94±0.57)LogMAR、(0.98±0.61)LogMAR、(0.96±0.69)LogMAR,术后1 d视力与术前比较，差异无统计学意义(P>0.05),但术后1周、1个月、6个月与术前视力比较，差异有统计学意义(P<0.05);术前眼压为(17.65±1.33)mmHg,术后1 d、1周、1个月、6个月眼压为(9.21±3.81)mmHg、(13.57±2.93)...

Simplifying silicone oil removal guided by ophthalmic endoscope

Objective To evaluatea simplified method of silicone oil removal using endoscope′s advantages. Methods Eighty-two cases (97 eyes) of endoscope-guided silicone oil removal from aphakic eyes or combined with cataract extraction were reviewed. Follow-up time was 27 to 60 months. Surgical time, pre-operative and 1 day, 1 week, 1 month and 6 month spostoperative visual acuity, intraocular pressure (IOP), corneal endothelial cell density as well as intra- and postoperative complications were recorded. Results Surgical time was 20.6 minutes (15.6-46.3 minutes). The best corrected visual acuity(BCVA)before operation was (2.04±0.58) LogMAR; and they were (1.92±0.79) LogMAR, (0.94±0.57) LogMAR, (0.98±0.61) LogMAR and (0.96±0.69) LogMAR 1 day,1 week, 1 month and 6 months after operation, respectively. There was no significant difference in BCVA between before and 1 day after operation (P>0.05); and there were statistical significant differences in BCVA among 1 week, 1 month and 6 months post-operation compared to pre-operation (P<0.05). The IOP was (17.65±1.33) mmHg before operation, and they were (9.21±3.81) mmHg, (13.57±2.93) mmHg, (14.75±3.60) mmHg and (15.15±2.32) mmHg 1 day, 1 week, 1 month and 6 months after operation, respectively. There was significant difference in IOP between before and 1 day after operation (P<0.05), while there was no statistical significant difference among 1 week, 1 month and 6 months post-operation compared to pre-operation (P>0.05). Compared with before operation, the corneal endothelial cell density was significantly increased 1 day, 1 week, 1 month and 6 months after operation among different sub-groups according to ages.There was significant difference in corneal endothelial cell density between pre-operation and 1 day post-operation (P<0.05), while there was no statistical significant difference among 1 week, 1 month or 6 months post-operation compared to pre-operation (P>0.05). Retinal detachment relapsed in 1 eye (1.03%). No silicone oil remnant or persistent corneal edema was found. Conclusion The endoscopy-guided simplified technique of silicone oil removal is safe, effective and economical.