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本文对118例进行玻璃体切割的复杂性视网膜脱离病例中66只联合硅油填充眼进行了总结。66只眼中有复发性视网膜脱离30只眼,其中20只眼是玻璃体切割联合膨胀性气体注入失败者。手术获得较好的疗效。在合并严重增殖性玻璃体视网膜病变的视网膜脱离中,眼外伤组的视网膜复位率达83％,非眼外伤组达82％,巨大裂孔性视网膜脱离达69％,后极部破孔性视网膜脱离达83％。血管性疾患合并牵拉性视网膜脱离的复位率达89％,糖尿病性牵拉性视网膜脱离复位率达80％。视力改善率除糖尿病性牵拉性视网膜脱离和巨大裂孔组约为60％以外,其余各组均高于75％。硅油填充后,白内障逐渐形成,部分患者发生硅油乳化、硅油进入前房、角膜带状变性、继发青光眼。尽管玻璃体切割联合硅油填充可以治疗复杂性视网膜脱离,特别是膨胀性气体填充失败的视网膜脱离,但硅油填充的并发症可能再次摧毁眼球,因此应严格掌握硅油填充术的使用范围。
In this paper, 118 cases of complex retinal detachment with vitrectomy combined with silicone filled eyes were summarized. Of the 66 eyes, there were 30 eyes with recurrent retinal detachment, of which 20 were failed with vitrectomy combined with expansive gas injection. Surgery to obtain a better effect. In retinal detachment with severe proliferative vitreoretinopathy, retinal detachment rate was 83% in ocular trauma patients, 82% in non-ocular trauma patients, 69% in macroscopic retinal detachment, and posterior pole ruptured retinal detachment 83%. The vascular disease combined with traction retinal detachment rate of 89%, the rate of diabetic retinopathy detachment rate of 80%. Visual acuity improvement rate except diabetic distraction retinal detachment and huge hole group was about 60%, the other groups were higher than 75%. After the filling of silicone oil, cataract gradually formed, some patients occurred silicone oil emulsion, silicone oil into the anterior chamber, corneal degeneration, secondary glaucoma. Although vitrectomy combined with silicone oil can treat complex retinal detachment, especially retinal detachment due to unsuccessful expander gas filling, the complications of silicone oil filling may destroy the eye again, so the use of silicone oil filling should be strictly controlled.