| ObjectiveTo observe the formation of epiretinal membrane in macular region after silicone oil filling, and analysis relevant factors about the epiretinal membrane in macular region secondary to silicone oil filling. To study the operation result about epiretinal membrane peeling in macular region secondary to silicone oil tamponade by observing eyes condition before and after operation. MethodsTo observe 410 patients(412 eyes) with silicone oil filled from March,2012 to March, 2014 who underwent vitrectomy combined with silicone oil tamponade because of retinal detachment because of various reasons in our hospital.They all hospitalized in our treatment group of Ophthalmology in The First Affiliated Hospital of Zhengzhou University.Record all patients’ age,gender, disease diagnosis,time of silicone oil tamponade,visual acuity(best corrected visual acuity before and after removal of intraocular silicone oil), intraocular pressure before removal of intraocular silicone oil, complications during the divesting epiretinal membrane in macular region, the thickness of macular retinal after epiretinal membrane peeling,best corrected visual acuity after epiretinal membrane peeling, recurrence of retinal detachment. Using SPSS 17.0 to processing the data, a = 0. 0 5, p < 0. 5 is the test ciiterion for statistical significance.Using Multivariate Logistic regression to analyse related factors contributing to secondary epiretinal membrane in macular region after silicone oil tamponade. Statistics of vision were analyzed by Kruskal-Wallis test, t test was used to analyze normally distributed data.To analyze the relation between age,g e n d e r, disease diagnosis,time of silicone oil tamponade and epiretinal membrane in macular region after silicone oil filling. Furtherly, to study the operation result about peeling epiretinal membrane in macular region after silicone oil filling by observing eyes condition before and after epiretinal membrane peeling. ResultsEpiretinal membrane in macular region after silicone oil filling appeared in 38 eyes among 412 eyes. Analyzing the relation between the patient’s gender、 age、primary disease、silicone oil tamponade time 、intraocular pressure before silicone oil removal and epiretinal membrane in macular region after silicone oil filling by Logistic Linear regression. Results showed that,patients’ age, primary diseases and silicone oil filling time had affects on the formation of epiretinal membrane in macular region after silicone oil filling.Retinal thickness of macular area in 38 eyes who appeard epiretinal membrane in macular region after silicone oil filling was(548±120) μm averagely,and were decreased by(127±104) μm、(283±95) μm 、(314±119) μm,1 month 、3 months 、6 months after the operation respectively compared with that of preoperation. Paired t test showed that differences were statistical significance,p=0.021(t=2.491)、p=0.014(t=2.697)、p=0.004(t=3.175).By the same way, differences were statistical significance between 1 month and 3 months, 3 months and 6 months,p=0.012(t=2.591)、p=0.008(t=2.953)respectively.In the 38 eyes who appeard epiretinal membrane in macular region after silicone oil filling, patients’ vision was slowly improving 1 month,3 months and 6 months after the operation of epiretinal membrane peeling(χ2=33.421,p=0.028; χ2=35.196,p=0.021;χ2=38.574,p=0.007).38 epiretinal membrane peeling patients had not been found the recurrent retinal detachment.In the 38 peeling patients, there were 12 eyes appeared punctate hemorrhage in ma c u l a r region,small drops of blood were absorbed in 3 to 7 days.And 9 eyes a p p e a r e d that partial macular proliferative membranes were closely connected to retina.,when we released proliferative membranes and leaved epiretinal membranes or internal limiting membrane,even though attempts in the peeling technique,They could’t be all stripped.In the 38 peeling patients,postoperative 33 eyes were filled with BSS, 5 eyes were filled with C3F8. Conclusion1.With a greater incidence of the epiretinal membrane in macular region after the silicone oil filling operation,whose occurrence rate was about 9.22%。This phenomenon has sometging to do with the patient’s age, primary diseases, silicone oil filling time.2.Combing silicone oil removal and epiretinal membrane peeling was helpful to improve the patient’s vision. Postoperation the retinal thickness in the macular area was declining gradually.3.For the patients of the secondary macular epiretinal membrane after the silicone oil filling operation,united with the epiretinal membrane peeling is a safe and effective way. With skilled operation, it generally does not increase the risk of recurrence of retinal detachment. |
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