[1]鲍庆,陈佳,邢怡桥,等.硅油眼复发性视网膜脱离的特点及临床处理[J].眼科新进展,2017,37(6):576-578.[doi:10.13389/j.cnki.rao.2017.0146]
　BAO Qing,CHEN Jia,XING Yi-Qiao,et al.Clinical characteristics and management of recurrent retinal detachment in silicone oil tamponade eyes[J].Recent Advances in Ophthalmology,2017,37(6):576-578.[doi:10.13389/j.cnki.rao.2017.0146]
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硅油眼复发性视网膜脱离的特点及临床处理/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年6期
页码:
576-578
栏目:
应用研究
出版日期:
2017-06-05

文章信息/Info

Title:
Clinical characteristics and management of recurrent retinal detachment in silicone oil tamponade eyes
作者:
鲍庆; 陈佳; 邢怡桥; 杜磊; 梅海峰
430060　湖北省武汉市，武汉大学人民医院眼科中心
Author(s):
BAO Qing; CHEN Jia; XING Yi-Qiao; DU Lei; MEI Hai-Feng
Department of Ophthalmology，Renmin Hospital of Wuhan University，Wuhan 430060，Hubei Province，China
关键词:
复发性视网膜脱离; 硅油眼; 玻璃体切割; 巩膜外加压
Keywords:
recurrent retinal detachment; silicone oil tamponade eye; vitrectomy; sclera buckling
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2017.0146
文献标志码:
A
摘要:
目的　探讨硅油眼复发性视网膜脱离的特点及手术方法的选择。方法　回顾性分析本院2012年1月至2015年12月硅油填充术眼复发视网膜脱离者134例（134眼），采用玻璃体切割联合硅油置换术或巩膜外加压术治疗，术后随访6个月，评价手术效果。结果　101眼采用玻璃体切割联合硅油置换治疗，术后79眼视网膜复位，22眼视网膜复位失败者再次行玻璃体切割手术，成功率为78.2%(79/101)；视力提高者16眼，不变者56眼，下降者29眼；眼压升高超过25 mmHg（1 kPa=7.5 mmHg）者31眼。33眼采用巩膜外加压治疗，23眼视网膜复位，10眼术后随访中发现视网膜未复位而改行玻璃体切割联合硅油置换术，成功率为69.7%(23/33)；视力提高者5眼，不变者16眼，下降者12眼；眼压升高超过25 mmHg者14眼。结论　对于下方或较周边的裂孔导致的局限性视网膜脱离，增生性玻璃体视网膜病变处于A或B级，屈光介质不影响眼底检查的病例，可选巩膜外加压术；对于裂孔位于后极部或较大裂孔导致的大范围视网膜脱离，并有较广泛的视网膜增殖或视网膜固定皱襞形成，建议选玻璃体联合硅油置换手术，松解牵拉，填充硅油。
Abstract:
Objective　To explore the characteristics and surgical managements of recurrent retinal detachment in silicone oil tamponade eyes.Methods　The records of consecutive series of 134 patients (134 eyes) with recurrent retinal detachment in silicone oil tamponade eyes from January 2012 to December 2015 in our hospital were reviewed retrospectively，the vitrectomy combined with silicone oil replacement or scleral buckling procedure were performed.The follow-up time was 6 months，the surgical efficient was evaluated.Results　101 eyes underwent vitrectomy combined with silicone oil replacement.Retina was completely reattached in 79 eyes，and vitrectomy was re-performed in the left 22 eyes，the successful rate was 78.2% (79/101)；The visual acuity improved in 16 eyes，unchanged in 56 eyes，decreased in 29 eyes；The intraocular pressure of 31 eyes increased more than 25 mmHg (1 kPa=7.5 mmHg).33 eyes underwent scleral buckling procedure.Retina was completely reattached in 23 eyes，and vitrectomy combined with silicone oil replacement was performed in the left 10 eyes，the successful rate was 69.7% (23/33)；The visual acuity improved in 5 eyes，unchanged in 16 eyes，decreased in 12 eyes；The intraocular pressure of 14 eyes increased more than 25 mmHg.Conclusion　For limited retinal detachment caused by inferior or peripheral holes，proliferative vitreoretinopathy in the A or B-class，the refractive medium does not affect the fundus examination，scleral buckling surgery is preferred；For the hole in the posterior pole or extensive retinal detachment caused by giant retinal holes，proliferation or retinal fixed fold formation，vitrectomy combined with silicone oil replacement is a better option.

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更新日期/Last Update: 2017-06-28