重硅油应用眼内短期填充15例临床分析

目的 探讨重硅油(Densiron-68)用于眼内填充治疗复杂性视网膜脱离的临床效果、并发症及安全性.方法 采用玻璃体切割联合重硅油眼内填充治疗视网膜脱离患者15只眼,分别为糖尿病视网膜病变、急性视网膜坏死、黄斑裂孔性视网膜脱离、巨大裂孔性视网膜脱离、伴有严重PVR的复发性孔源视网膜脱离,填充时间最少为40d,最长为12个月.观察重硅油填充期间及取出后视网膜复位情况及并发症等.结果 12只眼取出重硅油后在随访期间(2～4月)观察到视网膜保持复位,复位率80%(12/15);3只眼视网膜脱离复发,其中2只眼再次手术并普通硅油填充,1只眼拒绝取出重硅油,14只眼矫正视力较术前提高,1只眼视力无改善.主要并发症有白内障、后发白内障、硅油乳化、瞳孔粘连、乳化滴粘附于人工晶状体、术后PVR、硅油充满前房、硅油进入视网膜下等.结论 重硅油眼内填充治疗复杂性视网膜脱离疗效肯定,并提高患者舒适度,但并发症发生率高,只适宜短期填充,且需要密切随访.

The heavy silicon oil(Densiron-68)applies in the intraoctdar short-term fills 15 cases clinical analyses.

Objective To report and discuss the clinical efficiency,postoperative complications,and safety in patients after short-term Densiron 68 intraocular tamponade for complicated retinal detachment.Methods Fifteen patients were treated with par plana vitrectomy and heavy silicon oil (Densiron-68) tamponade,including diabetes retinopathy,acute retinal necrosis,macular hole retinal detachment,retinal detachment with giant retinal tear and rhegmatogenous retinal detachment with severe recurrent PVR.The tamponade persisted from 40 days to 12 months.The successfulness and complications were evaluated during and after removal of Densiron 68 intrancular tampouade.Results Anatomical success was achieved in 80% of cases (12/15) after removal of Densiron 68,retinal redetachment occurred in 3 patients.For the eyes with retinal redetachment,2 were re-operated with silicon oil tamponade,and 1 rejected to remove the heavy silicon oil.Best corrected visual acuity improved in 14 eyes,with no significant improvement in 1 eye.Complications included cataract development,posterior capsule opacification,emulsification and dispersion,pupillary synechiae,postoperative PVR,anterior chamber silicon oil and suhretina silicon oil.Conclusions Densiron 68 intraocular tamponade for compli cated retinal detachment positive effect and improve patient comfort,but the high inciodence of complications,only suitable for short-termfill adn the need for close follow-up.