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目的探讨硅油取出手术前预防性脉络膜缺损区边缘视网膜激光光凝对硅油取出手术后视网膜再脱离的影响。方法对63眼虹膜脉络膜缺损合并视网膜脱离硅油填充术后的临床资料进行回顾性分析。其中完全激光光凝组46眼;对照组17眼。观察两组患者硅油取出手术后视网膜再脱离的发生率、发生时间、原因;同时观察光凝对不同缺损类型患者的影响。结果硅油取出术后8眼发生了视网膜再脱离,其中完全激光光凝组2眼,占4.3%,对照组6眼,占35.5%。两组视网膜再脱离发生率比较,差异有统计学意义(P<0.05)。激光光凝的患者中最佳矫正视力下降6眼,占9.5%,眼前暗影5眼,占7.9%。结论预防性脉络膜缺损区边缘视网膜光凝对硅油取出手术后视网膜再脱离的发生率有关联,与裂孔的位置关系密切。
Objective To investigate the effect of retinal laser photocoagulation on retinal detachment after silicone oil removal surgery in patients with prophylaxis of preoperative silicone oil removal. Methods The clinical data of 63 eyes with iris choroidal defect and retinal detachment after silicone oil filling were retrospectively analyzed. Among them, 46 eyes were completely laser photocoagulation group and 17 eyes were in control group. The incidence of retinal detachment, the time of occurrence and the cause of retinal detachment after silicone oil removal were observed in both groups. The effects of photocoagulation on patients with different defect types were also observed. RESULTS: Retinal detachment occurred in 8 eyes after silicone oil was removed. There were 2 eyes in the complete laser photocoagulation group (4.3%) and 6 eyes (35.5%) in the control group. Retinal reattachment rate between the two groups, the difference was statistically significant (P <0.05). Among the patients with laser photocoagulation, the best corrected visual acuity decreased 6 eyes (9.5%) and the immediate anterior vision (5 eyes), accounting for 7.9%. Conclusion The incidence of retinal detachment after silicone oil extraction in peripheral retinal photocoagulation with preventive choroidal defect is related to the location of the hiatus.