硅油充填眼视网膜脱离原因分析及手术治疗

目的：探讨玻璃体切割联合硅油填充术后复发性视网膜脱离的原因及治疗方法，以便提高手术成功率。方法：回顾性分析我院3年来收治的31只硅油填充眼发生复发性视网膜脱离的原因，31只硅油填充眼进行二次手术，对不同情况分别采取硅油下剥膜、巩膜外垫压、视网膜前膜剥离、视网膜切开、眼内激光光凝等手术，再次眼内填充惰性气体3只眼。硅油21只眼，观察治疗效果。结果：31只硅油填充眼二次手术，视网膜解剖复位28眼，复位率为90％，部分复位3眼；术后视力提高者13眼41．9％，不变16眼。占51．6％，下降3眼，占9．7％。视网膜复位后硅油取出21眼，视网膜复位16眼，未复位5眼。结论：硅油填充眼的复发性视网膜脱离多以下方为主。术后增殖膜形成牵拉是造成硅油填充期间发生复发性视网膜脱离的主要原因。视网膜前膜剥离。视网膜切开，眼内激光光凝，再次眼内填充手术是治疗硅油填充眼复发性视网膜脱离的有效方法。

The cause and treatment of retinal detachment after silicone oil tamponades

Objective:To evaluate the reasons and the deal ways of the recurrent retinal detachment after silicone oil tamponades and improve the success rate of vitrectomy. The records of a consecutive series of 31 eyes with redetachment of retina after silicone oil tamponades surgery were reviewed retrospectively. Results:68% eyes showed recurrent inferior detachment.In 28 of 31 eyes the retina was reattached(90%) after secondary surgery.The postoperative visual acuity was improved in 13 eyes,reminded no change in 16 eyes and reduced in 3 eyes.In 21 of 16 eyes the retina was reattached(76%) after removal of silicone oil. Conclusions:Silicone oil-tamponaded eyes showed recurrent inferior detachment.The main causes of redetachment for silicone oil-tamponaded eyes were preretinal membrane proliferation.The techniques of preretinal membrane peeling,retinotomy,endophotocoagulation and tamponades can be effectively used in combination to treat the redetachment of retina after the silicone oil tamponades surgery.