硅油取出术后临床观察

目的：探讨硅油取出术的安全性和有效性，分析硅油乳化的危险因素。

方法：选取2012-11/2013-04在我院行硅油取出术的患者63例63眼，观察硅油取出手术前1d，手术后1，2，3d； 1mo眼压； 术前1d和术后1mo视力； 分析硅油取出术患者临床资料，探讨硅油乳化的危险因素。

结果：行硅油取出术63眼术后视网膜解剖复位57眼(90%)； 硅油取出手术前与术后各时间点眼压的差异具有统计学意义(P<0.05)，且手术后眼压较手术前降低； 术后1mo最佳矫正视力较术前提高37眼(59%)(P=0.002)，不变18眼(29%)，下降8眼(13%)； 硅油乳化23眼(37%)，与硅油乳化相关的危险因素为低密度脂蛋白升高(P<0.05)。

结论：硅油取出术后视网膜解剖复位率满意，术后眼压、视力改善明显，控制血脂水平可能减缓硅油乳化的发生。

Clinical observation on silicone oil removal

AIM: To investigate the safety and efficacy after removal of silicone oil, and to analyze risk factors for silicone oil emulsification.

METHODS: A retrospective analysis of 63 cases(63 eyes)underwent silicone oil removal in this hospital between November in 2012 and April in 2013. Intraocular pressure(IOP)was observed 1d before surgery, 1, 2, 3d; 1mo after surgery; vision was analyzed 1d before surgery and 1mo after surgery; clinical data of patients were analyzed and risk factors for silicone oil emulsification were explored.

RESULTS: After silicone oil removal in 63 eyes, retinal anatomic reduction was in 57 eyes(90%). The difference between preoperative and postoperative IOP at each time point had statistical significance(P<0.05), and postoperative IOP was lower than preoperative IOP. Compared with preoperative IOP, best-corrected visual acuity at one postoperative month was improved in 37 eyes(59%)(P=0.002), unchanged in 18 eyes(29%), and decreased in 8 eyes(13%). Silicone oil emulsion 23 eyes(37%), and risk factors associated with silicone oil emulsion was elevation of low density lipoprotein(LDL)(P<0.05).

CONCLUSION: The rate of retinal anatomic reduction is satisfactory after silicone oil removal. IOP and visual acuity were improved significantly after surgery. Control of cholesterol levels may slow down the process of silicone oil emulsion.