目的：探讨改良硅油取出联合巩膜扣带术治疗硅油填充状态下视网膜脱离的效果。

方法：回顾性研究。选取2021-01/2023-02于我院治疗的硅油填充状态下视网膜脱离的患者14例14眼，采用改良硅油取出联合巩膜扣带术进行治疗。硅油取出方法采用自制的23 G抽吸器，即将一次性输血器的针管取出，靠近乳头端剪至2.5-3.0 mm，另一端连接已去除推注手柄的10 mL注射器，注射器另一端连接玻璃体切割器的负压系统，进行硅油取出； 巩膜扣带术中外加压块采用外加压复合体； 术后未重新注入硅油。随访6 mo，观察术后视网膜复位、最佳矫正视力(BCVA)、眼压和并发症等情况。

结果：术后6 mo，视网膜完全复位13眼，视网膜复位率达93%，BCVA(LogMAR)较术前改善(0.95±0.18 vs 1.15±0.21，P=0.002)。术后1 d出现一过性高眼压6眼，药物控制后恢复正常。术中未见视网膜出血、嵌顿、医源性裂孔等并发症，术后未出现眼内炎、脉络膜脱离等并发症。

结论：改良硅油取出联合巩膜扣带术可以有效治疗硅油填充状态下视网膜脱离，促使视网膜再复位。

METHODS:The retrospective study included a total of 14 patients(14 eyes)who underwent treatment for retinal detachment with silicone oil tamponade at our hospital between January 2021 and February 2023. The modified silicon oil extraction combined with scleral buckling procedure was employed. A self-made 23-gauge suction device was applied in the silicon oil extraction, which involved removing the needle from a disposable blood transfusion set, trimming it to 2.5-3.0 mm near the beveled end, and connecting the other end to a 10 mL syringe without the plunger. The opposite end of the syringe was connected to the negative pressure system of the vitreous cutter to accomplish the silicon oil removal. Scleral compression blocks in scleral buckling surgery using a homemade composite device. No additional silicon oil was injected after the procedure. Follow-up was conducted for 6 mo, assessing retinal reattachment, best-corrected visual acuity(BCVA), intraocular pressure, and complications.

RESULTS: At the 6 mo follow-up, the retina was completely reset in 13 eyes, with a retinal reset rate of 93%, and an improvement in BCVA(LogMAR)compared with the preoperative period(0.95±0.18 vs 1.15±0.21, P=0.002). Transient high IOP occurred in 6 eyes at 1 d postoperatively and returned to normal after medication control. There were no intraoperative complications such as retinal hemorrhage, retinal incarceration, or iatrogenic retinal breaks, and no postoperative complications such as endophthalmitis or choroidal detachment.

CONCLUSIONS:Modified silicone oil removal combined with scleral buckling can effectively treat retinal detachment in the silicone oil tamponade and induce retinal reattachment.