目的:观察重硅油作为眼内填充物治疗硅油眼复发性视网膜脱离的临床效果。方法:2008-01/2009-06期间我院收治的硅油眼复发性视网膜脱离患者9例9眼,均采用取油、剥膜、视网膜复位、重硅油填充术。其中男6例,女3例;年龄23～45(平均33.78±6.89)岁;原有眼球穿通伤6例、孔源性视网膜脱离3例;伴不同程度的视网膜前及下增殖。重硅油填充术前手术次数1～3次,接受1次手术1例、2次手术5例、3次手术3例。患者随访观察时间3～10mo。所有患者先行硅油取出然后依病情联合剥膜、重水应用、激光、冷凝、气液交换等,最后行重硅油填充。结果:术后1wk全部病例视网膜均获复位,复位率100%。随访期间总共4例发生视网膜再脱离,视网膜脱离最早出现为术后1.5mo,最迟出现为术后3mo,2例为重硅油存留时发生,2例为重硅油取出术后,复位率56%;最后一次随访时视力较术前改善者5例,改善率56%;7例术后眼压较术前有升高,药物均可控制;9例术后前房均有反应,且持续时间较长,2～3mo;本组病例重硅油填充术后均发生乳化现象,最短2wk即发现乳化小滴,最长3mo,平均2.08±0.58mo。结论:重硅油填充治疗复杂性视网膜脱离应严格掌握适应证、密切随访观察减少并发症的发生。

·AIM:To assess the clinical setting of heavy silicone oil tamponade(Densiron-68)for retinal detachment after silicone oil tamponade.·METHODS:Nine eyes of 9 patients with retinal detachment after silicone oil tamponade were recruited between January 2008 and June 2009.Densiron-68 was used in all cases.Among these cases there were 6 men and 3 women.The youngest was 23 years old,the oldest was 45 years old,the mean age was 33.78±6.89.Among these cases there were 6 cases of perforating injury of eyeball,3 cases of rhegmatogenous detachment of retina.9 cases have secondary proliferative vitreoretinopathy.Surgical techniques included silicone oil removal,membrane peeling,heavy water application,air-fluid exchange,endophotocoagulation,cryocoagulation,Densiron-68 endotamponade et al ·RESULTS:The rate of retinal attachment one week after Densiron-68 endotamponade was 100%.While recurrent retinal detachment appeared in 4 cases during the follow-up time.The earliest re-detachment occurred 1.5 months after the operation,the latest occurred 3 months after the operation.2 cases occurred in eyes with Densiron-68 endotamponade and 2 cases occurred after Densiron-68 removal.Visual acuity was improved in 5 patients by the last follow-up,the improvement rate was 56%;7 cases had increased IOP compared with the preoperation,and could be controled by medicine;the anterior chamber reaction was found in all case.Heavy silicone oil emulsification occurred in all case,the shortest time of emulsification was two weeks,the longest was 3 months,with an average of 2.08±0.58 months.·CONCLUSION:The desirable attitude about heavy silicone oil in complicated retinal detachment is to control indications strictly,observe closely.·

R779.6