复杂性视网膜脱离硅油注入手术后视神经萎缩多因素回归分析

摘要 目的探讨复杂性视网膜脱离玻璃体视网膜手术中硅油注入手术后视神经萎缩发生的危险因素。 方法 回顾性分析97例硅油注入手术后发生视神经萎缩患者的临床资料，采用SPSS统计软件对患者年龄、既往史、原发疾病、手术前眼部情况、手术中并发症、手术后并发症、取硅油时间及取硅油时眼部情况、硅油乳化等因素进行Logistic多因素回归分析，P≤0.05为差异有统计学意义。 结果 所有患眼视盘边界清晰，色泽变淡者65只眼，苍白者21只眼，色泽变淡且杯盘比明显增大（≥0.6 ）者11只眼。Logistic多因素回归分析，逐步排除混杂因素后，取硅油时眼压（P=0.02.2）及视力（P=0.001）进入回归方程。 结论 硅油注入手术后的慢性眼压升高是发生视神经萎缩的相关因素。 (中华眼底病杂志, 2006, 22: 305-307)

Regression analysis of risk factors of optic nerve atrophy in eyes with complicated retinal detachment after silicone oil tamponade

Objective To investigate the characteristics and risk factors of optic nerve atrophy in eyes with complicated retinal detachment after silicone oil tamponade during the procedure of vitreoretinal operation. Methods The clinical data of 97 patients with complicated retinal detachment who had optic nerve atrophy after silicone oil tamponade during the procedure of vitreoretinal operation were an alyzed retrospectively. Logistic regression analysis by SPSS statistical software was used to analyze the factors like age, disease history, primary diseases, preoperative ocular condition, complications in and after the operation, the time taking out the silicone oil, and emulsification of the silicone oil, and P≤0.05 was considered to be the symbol of significant difference. Results All of the affected eyes had optic discs with clear border, including paler optic disc in 65 eyes, pale one in 21 eyes, and paler optic disc with enlargement of the cup/disc (≥ 0.6) in 11 eyes. The result of logistic regression analysis showed that the intraocular pressure (P=0.022) and the visual acuity (P=0.001) during the silicone oil removal were in the equation. Conclusion The risk factor of optic nerve atrophy is the chronic increase of intraocular pressure after silicone oil tamponade. (Chin J Ocul Fundus Dis, 2006, 22: 305-307)