| Background and ObjectiveOcular trauma as a blinding eye disease is very common in clinical practice, its consequences not only affect visual function, but also leave a disability, even loss of the ability to work, the losses and the impact on family and social is obvious. Ocular trauma is an important issue of Ophthalmology Prevention of Blindness. Blindness prevention and make every effort to improve the treatment level is the purpose of the study of ocular trauma. Ocular trauma is often associated with a variety of complexity complications, it is quite tricky to handle. With the progress of science and technology, the cure rate of eye injury has been significantly improved. Especially silicone oil as intraoperative tamponade has been used in clinical,some are used to regard as incurable eye injury are treated very good. However, some complications of postoperative have becoming new problems.Proliferative vitreoretinopathy (PVR) is a common complication of ocular trauma, also contributed to the failure of the procedure and the poor prognosis vision. Learning the progress of postoperative PVR after silicone oil injection,to the benefit of making appropriate diagnosis and treatment plan in advance, avoiding recurrent retinal detachment and improving the success rate of surgery. This study assessed clinical variables as risk factors for the development of postoperative PVR,attempted to determine the best time of removing silicone oil. Methods96patients (96eyes) who undergoing vitrectomy combined with intraocular silicone oil filling surgery for the first time after eye injuries,were selected from July2011to September2012in our hospital. The first time follow-up was planed in three weeks later after operation. The subsequent reviews were made once a month, the longest was20months. Eyes condition was recorded in patients during the follow-up. Logistic regression analysis the risk factors of PVR, the period of PVR occur and static, timing of silicone oil removal.ResultsDuring96cases,64cases (66.7%) postoperative PVR.Logistic regression analysis of risk factors (P<0.05)are scleral wound (OR=9.495, P=0.023)and injured-operation time>14days (OR=13.392, P=0.016).64cases of patients with postoperative PVR,1case PVR occurred in three weeks,49cases in seven weeks,14cases were observed at11weeks.PVR occurred in seven weeks had obvious advantages (OR=29.403, P<0.05).Continuous observation of60patients,54cases PVR stop developing in11weeks after surgery,6cases in15weeks, between the two, PVR stop developing in11weeks has significant advantages (OR=167.926, P<0.05).The prognosis of visual acuity improve in65cases (67.7%), unchanged in20cases (20.8%), a decrease of11cases (11.5%), and there was relationship between the prognosis and preoperative(r=0.354, P=0.01).23cases undergoing silicone oil removal during three months, recurrent retinal detachment happened in5cases (21.7%), silicone oil removal during3-6months in62cases,2cases had recurrent retinal detachment(3.2%), One of four people removed silicone oil more than6months happened recurrent retinal detachment (25%). Comparison of the three, within six months, with time goes on recurrent retinal detachment rate was significantly decreased (P<0.05).More than six months, recurrent retinal detachment and silicone oil-filled time had no significant correlation (OR=6.533, P=0.088). ConclusionVitrectomy combined with silicone oil filling have the good effect on complicated ocular trauma,but66.7%patients developed postoperative PVR.Scleral wound, injured-operation time are closely related to postoperative PVR. PVR formation in seven weeks after silicone oil injection, and stoped at11weeks. For the longer couse of postoperative PVR, extend silicone oil filling time to ensure the retina reached the more steady condition.To achieve the ultimate goal of decreasing the happening of recurrent retinal detachment. |
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