摘要目的:比较玻璃体切割术后3种方法取出硅油的时间与速率.方法:前瞻性临床研究.连续收集2016年10月至2017年6月于温州医科大学附属眼视光医院行玻璃体腔硅油取出术的患者52例(52眼),其中19眼采用注射器手动取油(A组),17眼采用玻璃体切割机取油(B组),16眼采用改良玻璃体切割机取油(C组).3组均做23G两通道.A组将一小段输血管两端分别连于10 ml注射器头部与23G套管,将注射器活塞拉至底部固定后开始吸出硅油;B组将输血管一端连接23G套管,另一端连接玻璃体切割机;C组将输血管膨大部分与23G套管相连,另一端连接玻璃体切割机.B组与C组的负压由玻璃体切割机提供.记录3组的取油时间与速率(即单位时间取出的硅油量).3组间数据比较采用方差分析法和Fisher确切概率法.结果:A、B、C组取油时间分别为(4.2±1.4) min、(6.1±1.5)min、(5.1±1.2) min,3组间总体差异有统计学意义(F=8.9,P＜ 0.001),且A组取油时间短于B组与C组,差异均有统计学意义(P＜0.05).A、B、C组取油速率分别为(1.42±0.31) ml/min、(0.94±0.21) ml/min、(1.14±0.20)ml/min,3组间总体差异有统计学意义(F=18.0,P＜0.001),且A组取油速率高于B组与C组,C组高于B组,差异均有统计学意义(P＜0.05).A、B、C组术后第1天低眼压(≤6 mmHg)发生率分别为1/19、0/17、1/16 (P=0.76),但均在术后1周恢复正常.硅油取出速率与硅油填充时间无相关性.3组所有患者术中与术后均无其他严重并发症发生.结论:3种硅油取出方法均安全有效,其中注射器手动取油法时间较短,速率较高.

abstractsObjective:To compare the silicone oil removal time and rate of three different methods.Methods:This clinical study included one eye from each of 52 consecutively enrolled patients who underwent silicone oil removal at the Eye Hospital,Wenzhou Medical University from October 2016 to July 2017.The patients were categorized into three groups for intraocular silicon oil removal:manual (Group A=19),vitrectomy (Group B,n=17),and modified vitrectomy (Group C,n=16).For Group A,a 10 ml syringe was connected to the 23-gauge cannula through a short section of blood transfusion tube.The oil was removed by pulling the plunger to the end where it was held to create sufficient negative pressure.For Group B,the small side of a blood transfusion tube was connected to the cannula on one side of the eye while the other side was connected to a vitrectomy apparatus.For Group C,the expanded side of a blood transfusion tube was connected to the cannula on one side of the eye while the other side was connected to a vitrectomy apparatus.The negative pressure of Group B and Group C was provided by the vitrectomy apparatus.Silicone oil removal time and rate (volume divided by the time taken for removal) were recorded.All statistical analyses were performed using analysis of variance and Fisher exact test.Results:The mean times of silicone oil removal in Groups A,B,and C were 4.2 ± 1.4 min,6.1 ± 1.5 min,and 5.1 ± 1.2 min respectively (F=8.9,P＜ 0.001).Furthermore,the mean time for Group A was shorter than for Groups B and C in pairwise comparisons (P ＜ 0.05).The silicone oil removal rate in Groups A,B,and C were 1.42±0.31 ml/min,0.94±0.21 ml/min,and 1.14±0.20 ml/min respectively (F=18.0,P＜0.001).Moreover,the removal rate for Group A was higher than for Groups B and C,and Group C was higher than Group B in pairwise comparisons (P ＜ 0.05).The incidence of low intraocular pressure (≤ 6 mmHg) at day 1 after surgery in Groups A,B,and C were 1/19,0/17,and 1/16 respectively (P=0.76).Recovery of all intraocular pressures was achieved by 1 week after surgery.No other severe intraoperative or postoperative complications were noted for three approaches.Conclusions:All three methods for removal of intraocular silicon oil were safe and efficient.The removal time of the manual approach was the shortest and the rate was the highest of the three approaches.