CAJ | 학술논문

目的探讨提前取出硅油的原因和再次手术后的效果.方法对2005年1月至2012年6月在中山眼科中心,选择硅油注入眼内不足2个月(61天)并有完整病例资料的36例(36只眼),提前行硅油取出原因及再次手术后效果.术后随访≥6个月,记录患者最佳矫正视力、眼压及视网膜复位情况.结果提前硅油取出原因中视网膜未复位18只眼(50％,18/36);难以控制的高眼压8只眼(22.2％,8/36);黄斑前膜4只眼(11.1％,4/36);硅油入前房或者硅油乳化5只眼(13.9％,5/36);眼内出血1只眼(2.8％,1/36).术后视力提高者22只眼(占61.1％,22/36),不变者9只眼(占25％,9/36),5只眼(占13.9％,5/36)轻度下降.高眼压原因(8只眼)取油者术前平均眼压(36.54±11.35) mmHg,术后平均眼压(13.13±6.93) mmHg,差异有统计学意义(P＜0.01).共6只眼术后发生视网膜脱离,再次手术后4只眼视网膜复位,总复位率为94.4％ (34/36).结论早期硅油取出的原因主要是视网膜脱离和难以控制的高眼压,其他是黄斑前膜和硅油入前房和乳化,及时取出硅油和处理原发原因,可挽救患者视功能.
목적 탐토제전취출규유적원인화재차수술후적효과.방법 대2005년1월지2012년6월재중산안과중심,선택규유주입안내불족2개월(61천)병유완정병례자료적36례(36지안),제전행규유취출원인급재차수술후효과.술후수방≥6개월,기록환자최가교정시력、안압급시망막복위정황.결과 제전규유취출원인중시망막미복위18지안(50％,18/36);난이공제적고안압8지안(22.2％,8/36);황반전막4지안(11.1％,4/36);규유입전방혹자규유유화5지안(13.9％,5/36);안내출혈1지안(2.8％,1/36).술후시력제고자22지안(점61.1％,22/36),불변자9지안(점25％,9/36),5지안(점13.9％,5/36)경도하강.고안압원인(8지안)취유자술전평균안압(36.54±11.35) mmHg,술후평균안압(13.13±6.93) mmHg,차이유통계학의의(P＜0.01).공6지안술후발생시망막탈리,재차수술후4지안시망막복위,총복위솔위94.4％ (34/36).결론 조기규유취출적원인주요시시망막탈리화난이공제적고안압,기타시황반전막화규유입전방화유화,급시취출규유화처리원발원인,가만구환자시공능.
Objective To investigate the reason and effect of early silicone oil removal.Methods A total of 526 cases (526 eyes) with silicone oil removal from January 2005 to June 2012 were reviewed.Among them,36 cases (36 eyes) that were removed silicone oil less than two months (61 days) and had complete clinical data were selected.The reason and effect of silicone oil removal for the 36 cases (36 eyes) were analyzed retrospectively.All of the cases were followed up for more than 6 months.The best corrected visual acuity,intraocular pressure and reattachment of retina were recorded.Results The reason of early silicone oil removal included retinal detachment (18 eyes,50％,18/36),high intraocular pressure (8 eyes,22.2％,8/36),macular epiretinal membrane (4 eyes,11.1％,4/36),silicone oil into the anterior chamber or emulsification (5 eyes,13.9％,5/36) and intraocular hemorrhage (1 eye,2.8％,1/36).Best corrected visual acuity improved in 22 eyes (61.1％,22/36),stabled in 9 eyes (25％,9/36) and descended in 5 eyes (13.9％,5/36).The average intraocular pressure of 8 eyes with high intraocular pressure was 13.13±6.93mmHg compared with that before operation (36.54±11.35mmHg).There was significant difference (P ＜0.01).Recurrent retinal detachment came out for 6 eyes and retina was reattached for 4 eyes after the second operation.The total effective rate was 94.4％ (34/36).Conclusions Retinal detachment and high intraocular pressure are the main reasons why silicone oil is removed earlier.Macular preretinal membrane and silicone oil into the anterior chamber or emulsified may also be reasons.Removing silicone oil timely and dealing with the primary reasons can save visual function.