关键词: 玻璃体视网膜手术, 硅油, 并发症

Abstract: Objective To study the clinical necessity and feasibility of long-term intravitreal silicone oil tamponade after vitreo-retinal surgery in severe ocular injury. Design Retrospective case series. Participants 18 patients (18 eyes) treated in Ocular Trauma Department of Beijing Tongren Eye Center from 2005 to 2010 were followed up, whose time of intravitreal silicone oil tamponade was at least 2 years. Method A standard 20G pars plana vitrectomy was performed in all cases with ordinary silicone oil tamponade at the end of surgery. Visual acuity, intraocular pressure, slit lamp microscopy and ocular fundus were examined every 3 months during follow-up. Main Outcome Measures  Ocular manifestation of silicone oil eyes. Results All 18 patients were male with a mean age of 37.83±14.92 years. The causes of vitreo-retinal surgery were ocular trauma (17 cases) and acute retinal necrosis (1 case). The retaining time of intravitreal silicone oil was 2-14 years with mean retaining time of 6.41±3.97 years. During the follow-up silicone oil was removed in 3 patients for severe silicone emulsification. Silicone oil was reserved in 15 patients in which 8 patients (53.33%) for saving eyeball, 3 patients (20%) for single eye, 2 patients (13.33%) for repeated operation and 2 patients (13.33%) for hypotony. The corrected visual acuity of patients after operation was from no light perception to 0.2. The retina of 15 patients (83.33%) was reattached and the retina of 3 patients (16.67%) was still not attached. The main complication of long-term intravitreal silicone oil retaining was secondary glaucoma (33.33%), corneal degeneration (27.78%) and silicone oil emulsification (22.22%). Conclusion In cases of complex ocular trauma, single eye, multiple vitreo-retinal surgeries, hypotony, and retinal redettachment or retina in place but with marked proliferation, silicone oil can be retained in the eyes for long time to preserve the aspect of eyeball and the visual acuity of patients when the complication of silicone oil are treated promptly and correctly. (Ophthalmol CHN, 2013, 22: 58-61)

Key words: vitreo-retinal surgery, silicone oil, complication