Treatment for Retinal Detachment in Silicone Oil-filled Eyes by Scleral Buckling and Retinal Laser Coagulation_West China Medical Journal

Authors：

WANG Liang ¹ ,  ZHANG Hongbing ^1,2 , WANG Xiaodong. ¹

1. Department of Ophthalmology, the First Hospital of Xi’an, Xi’an, Shaanxi 710002, P. R. China; 2. Eye Institute of Shaanxi Province, Xi’an, Shaanxi 710002, P. R.China;

Corresponding author：

ZHANG Hongbing, Email: wangliang-118@163.com

Keywords：

视网膜脱离; 硅油眼; 巩膜外环扎; 眼内激光光凝

DOI：

10.7507/1002-0179.20130534

Video：

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目的　研究巩膜外垫压手术联合视网膜激光光凝对硅油眼视网膜脱离的治疗效果。方法　回顾性分析2009年1月－2012年1月，用巩膜外垫压联合视网膜光凝手术治疗36例硅油眼视网膜脱离的视网膜复位效果。结果　全部患者均顺利完成巩膜外垫压手术及随后的视网膜激光光凝，行巩膜外放液5只眼，手术中未发生视网膜嵌顿、眼内出血和眼压显著升高等并发症；手术后1周视网膜复位21只眼（58.33%），剩下15只眼1个月后复位7只眼（19.44%），视网膜脱离总复位率为28只眼（77.77%）；未复位8只眼（22.23%），改用玻璃体切割手术方式，视网膜成功复位；6个月后取出硅油，随访6个月视网膜无脱离或者脱离范围增加；手术后眼压≥30 mm Hg （1 mm Hg=0.133 kPa）3只眼，≥20 mm Hg 7只眼，对症治疗1周后眼压均恢复到正常范围。结论　巩膜外垫压联合视网膜激光光凝治疗硅油眼视网膜脱离，手术简单，复位率高，可为硅油眼视网膜脱离首选手术方式，对于巩膜外垫压手术失败和复杂的硅油眼视网膜脱离，应当选择玻璃体切割手术方式。

Citation： WANG Liang,ZHANG Hongbing,WANG Xiaodong.. Treatment for Retinal Detachment in Silicone Oil-filled Eyes by Scleral Buckling and Retinal Laser Coagulation. West China Medical Journal, 2013, 28(11): 1692-1694. doi: 10.7507/1002-0179.20130534 Copy

1.	莫宾, 刘武, 陈惠茹. 硅油填充术后视网膜再脱离的分析与处理[J]. 眼科, 2006, 15(6): 419-421.
2.	Lepori L, Matteoli E, Spanedda A, et al. Combined use of perfluorohexyloctane and silicone oil as intraocular tamponade: an in vitro study[J]. Graefes Arch Clin Exp Ophthalmol, 2006, 244(1): 79-82.
3.	Joussen AM, Wong D. The concept of heavy tamponades-chances and limitations[J]. Graefes Arch Clin Exp Ophthalmol, 2008, 246(9): 1217-1224.
4.	Hussain RN, Banerjee S. Densiron 68 as an intraocular tamponade for complex inferior retinal detachments[J]. Clin Ophthalmol, 2011, 5: 603-607.
5.	Ozdek S, Yuksel N, Gurelik G, et al. High-density silicone oil as an intraocular tamponade in complex retinal detachments[J]. Can J Ophthalmol, 2011, 46(1): 51-55.
6.	Wickham L, Tranos P, Hiscott P, et al. The use of silicone oil-RMN3 (Oxane HD) as heavier-than-water internal tamponade in complicated inferior retinal detachment surgery[J]. Graefes Arch Clin Exp Ophthalmol, 2010, 248(9): 1225-1231.
7.	雷春灵, 王睿, 毕春潮, 等. 重硅油填充术治疗硅油眼复发性视网膜脱离9例临床观察[J]. 国际眼科杂志, 2010, 10(11): 2111-2113.
8.	程扬, 曾水清, 李小青, 等. 单纯巩膜扣带术治疗硅油填充眼视网膜脱离[J]. 眼科新进展, 2004, 24(3): 211-212.
9.	韩泉洪, 王琳, 程伟, 等. 硅油眼复发性视网膜脱离的巩膜外垫压治疗[J]. 中国实用眼科杂志, 2002, 20(11): 826-827.
10.	张国明, 张少冲, 曾键, 等. 硅油下玻璃体视网膜手术治疗复发性视网膜脱离[J]. 眼科新进展, 2006, 26(3): 198-199.
11.	张少冲, 高汝龙, 吴启崇. 硅油充填术后下半象限复发性视网膜脱离的再手术探讨[J]. 中国实用眼科杂志, 1996, 14(6): 343-345.
12.	梅海峰, 邢怡桥, 杨安怀, 等. 经巩膜双通道行硅油填充眼视网膜脱离复位术的临床观察[J]. 中国实用眼科杂志, 2004, 22(3): 191-192.
13.	姜燕荣, 黎晓新. 硅油下视网膜复位术疗效探讨[J]. 中华眼科杂志, 1999, 35(6): 416.
14.	刘英. 硅油填充眼视网膜脱离的手术治疗[J]. 中华眼底病杂志, 2001, 17(3): 214-215.
15.	Quiram PA, Gonzales CR, Hu W, et al. Outcomes of vitrectomy with inferior retinectomy in patients with recurrent rhegmatogenous retinal detachments and proliferative vitreoretinopathy[J]. Ophthalmology, 2006, 113(11): 2041-2047.
16.	Ahmadieh H, Feghhi M, Tabatabaei H, et al. Triamcinolone acetonide in silicone-filled eyes as adjunctive treatment for proliferative vitreoretinopathy: a randomized clinical trial[J]. Ophthalmology, 2008, 115(11): 1938-1943.
17.	梅海峰, 邢怡桥, 杨安怀, 等. 硅油填充眼下方复发性视网膜脱离的氩激光光凝治疗[J]. 中国实用眼科杂志, 2004, 22(6): 436-437.
18.	Steel DH, Weir P, James CR. Silicone assisted, Argon laser confinement of recurrent proliferative vitreoretinopathy related retinal detachment: a technique to allow silicone oil removal in problem eyes[J]. Br J Ophthalmol, 1997, 81(9): 765-770.
19.	Machemer R, Aaberg TM, freeman HM, et al. An updated dassification of retinal detachment with proliferative vitreretinopathy[J]. Am J Ophthalmol, 1991, 112(2): 159-165.

1. 　莫宾, 刘武, 陈惠茹. 硅油填充术后视网膜再脱离的分析与处理[J]. 眼科, 2006, 15(6): 419-421.
2. 　Lepori L, Matteoli E, Spanedda A, et al. Combined use of perfluorohexyloctane and silicone oil as intraocular tamponade: an in vitro study[J]. Graefes Arch Clin Exp Ophthalmol, 2006, 244(1): 79-82.
3. 　Joussen AM, Wong D. The concept of heavy tamponades-chances and limitations[J]. Graefes Arch Clin Exp Ophthalmol, 2008, 246(9): 1217-1224.
4. 　Hussain RN, Banerjee S. Densiron 68 as an intraocular tamponade for complex inferior retinal detachments[J]. Clin Ophthalmol, 2011, 5: 603-607.
5. 　Ozdek S, Yuksel N, Gurelik G, et al. High-density silicone oil as an intraocular tamponade in complex retinal detachments[J]. Can J Ophthalmol, 2011, 46(1): 51-55.
6. 　Wickham L, Tranos P, Hiscott P, et al. The use of silicone oil-RMN3 (Oxane HD) as heavier-than-water internal tamponade in complicated inferior retinal detachment surgery[J]. Graefes Arch Clin Exp Ophthalmol, 2010, 248(9): 1225-1231.
7. 　雷春灵, 王睿, 毕春潮, 等. 重硅油填充术治疗硅油眼复发性视网膜脱离9例临床观察[J]. 国际眼科杂志, 2010, 10(11): 2111-2113.
8. 　程扬, 曾水清, 李小青, 等. 单纯巩膜扣带术治疗硅油填充眼视网膜脱离[J]. 眼科新进展, 2004, 24(3): 211-212.
9. 　韩泉洪, 王琳, 程伟, 等. 硅油眼复发性视网膜脱离的巩膜外垫压治疗[J]. 中国实用眼科杂志, 2002, 20(11): 826-827.
10. 　张国明, 张少冲, 曾键, 等. 硅油下玻璃体视网膜手术治疗复发性视网膜脱离[J]. 眼科新进展, 2006, 26(3): 198-199.
11. 　张少冲, 高汝龙, 吴启崇. 硅油充填术后下半象限复发性视网膜脱离的再手术探讨[J]. 中国实用眼科杂志, 1996, 14(6): 343-345.
12. 　梅海峰, 邢怡桥, 杨安怀, 等. 经巩膜双通道行硅油填充眼视网膜脱离复位术的临床观察[J]. 中国实用眼科杂志, 2004, 22(3): 191-192.
13. 　姜燕荣, 黎晓新. 硅油下视网膜复位术疗效探讨[J]. 中华眼科杂志, 1999, 35(6): 416.
14. 　刘英. 硅油填充眼视网膜脱离的手术治疗[J]. 中华眼底病杂志, 2001, 17(3): 214-215.
15. 　Quiram PA, Gonzales CR, Hu W, et al. Outcomes of vitrectomy with inferior retinectomy in patients with recurrent rhegmatogenous retinal detachments and proliferative vitreoretinopathy[J]. Ophthalmology, 2006, 113(11): 2041-2047.
16. 　Ahmadieh H, Feghhi M, Tabatabaei H, et al. Triamcinolone acetonide in silicone-filled eyes as adjunctive treatment for proliferative vitreoretinopathy: a randomized clinical trial[J]. Ophthalmology, 2008, 115(11): 1938-1943.
17. 　梅海峰, 邢怡桥, 杨安怀, 等. 硅油填充眼下方复发性视网膜脱离的氩激光光凝治疗[J]. 中国实用眼科杂志, 2004, 22(6): 436-437.
18. 　Steel DH, Weir P, James CR. Silicone assisted, Argon laser confinement of recurrent proliferative vitreoretinopathy related retinal detachment: a technique to allow silicone oil removal in problem eyes[J]. Br J Ophthalmol, 1997, 81(9): 765-770.
19. 　Machemer R, Aaberg TM, freeman HM, et al. An updated dassification of retinal detachment with proliferative vitreretinopathy[J]. Am J Ophthalmol, 1991, 112(2): 159-165.

West China Medical Journal

Treatment for Retinal Detachment in Silicone Oil-filled Eyes by Scleral Buckling and Retinal Laser Coagulation

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