摘要
目的探讨巩膜扣带术后发生硅胶暴露或硅胶感染患者的临床表现、治疗措施和治疗效果。方法回顾性分析由我院收治的巩膜扣带术后发生硅胶暴露或硅胶感染的6例(6只眼)患者的临床表现。经拆除巩膜硅胶后,了解患者症状是否消除,视力是否发生变化,视网膜是否再次发生脱离以及细菌培养结果。结果 4例发生硅胶暴露的患者中有3例仅有异物感,不伴结膜充血和疼痛以及脓性分泌物等临床感染症状,1例患者伴血泪和脓性分泌物,在拆除外加压块后送检行细菌培养显示阴性。其他2例无硅胶暴露,其中1例眼红痛,脓性分泌物增多伴结膜息肉,另1例眼红痛,脓性分泌物增多伴结膜囊肿和复视。两例患者送检的硅胶细菌培养均是金黄色葡萄球菌。术后视力无变化的有3例,视力提高的有2例,视力降低的有1例。术后随访4~31个月,随访期内所有患者症状完全消除,视网膜未再发生脱离。结论硅胶拆除术可以有效治疗巩膜扣带术后硅胶暴露或硅胶感染,该手术安全有效。
Objective To investigate the clinical manifestation, therapeutic intervention and related clinical effect of patients with silicone exposure or infection after the scleral buckling surgery. Methods We retrospectively reviewed the clinical manifestations of 6 patients(6 eyes) who developed silicone exposure or infection after the scleral buckling surgery in our hospital. After removing the scleral silicone, the change in clinical presentation, visual acuity, recurrence of retinal detachment, and the bacterial culture results were assessed. Results Three of the four patients with silicone exposure only had foreign body sensation, without clinical infection symptoms such as conjunctival hyperemia, pain or purulent discharge. One patient presented with blood tears and purulent discharge, and the bacteria culture was negative after removing the buckle. The other two patients had no silicone exposure, including one with eye redness, pain, purulent secretions and conjunctival polyp, and the other one with conjunctival congestion, purulent secretions, conjunctival cysts and diplopia. Staphylococcus aureus was identified in the removed silicone during bacterial culture in both patients. The postoperative visual acuity was unchanged in 3 cases, improved in 2 cases and decreased in 1 case. Patients were followed up for 4 to 31 months postoperatively, during which symptoms of all patients disappeared and there was no reoccurrence of retinal detachment. Conclusions Silicone removal can be used as a safe and effective treatment for silicone exposure or infection after the scleral buckling surgery.
作者
胡迪
柯根杰
董凯
Hu Di;Ke Genjie;Dong Kai(Department of Ophthalmology,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230000,China)
出处
《临床眼科杂志》
2019年第3期266-269,共4页
Journal of Clinical Ophthalmology
关键词
巩膜扣带术
硅胶暴露
硅胶感染
Scleral bucking surgery
Silicone exposure
Silicone infection
