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目的:评估晶状体及囊膜状态对硅油填充眼屈光状态的影响,并探讨临床中与硅油填充眼屈光度改变有关的影响因素。方法:选择作硅油取出手术69只眼的病例资料。所填充硅油均为德国ACRITEC公司产品(粘度5000cps,屈光指数1.404);硅油填充玻璃体腔容积约4/5,眼底镜下新月形分界面清晰可见;硅油填充时间2-36个月,平均(7.49±6.01)个月。取油手术前1-3天,作检影验光;少数病例作B超检查了解眼内硅油泡形态、位置、与毗邻组织关系等情况。取油后4周复查时常规作视力、验光、眼压、眼底检查。前后两次检得的术眼屈光度差值作为取油后屈光度改变量。结果:69只眼分为三组:有晶状体组(n=34)、无晶状体囊膜完整组(n=22)及无晶状体无囊膜组(n=13)。各组取油后屈光度改变分别为-9.23±-2.82D、1.09±2.50D以及5.47±2.97D,各组数据之间比较存在统计学差异(均P<0.01)。各组内屈光度改变量个体差异均较大。在有晶状体组中,多元线性回归分析显示:年龄、性别、眼别、硅油填充时间、正常范围内眼压等因素均与屈光度改变无关,但与硅油填充前屈光度有关。结论:有晶状体眼、无晶状体囊膜完整眼及无囊膜眼中取油后屈光度改变均值各组内个体差异大。有晶状体时,手术前后的屈光度改变与年龄、性别、眼别、硅油填充时间、正常范围内眼压等因素无关,但与硅油填充前的术眼屈光度有关。理论推导参数或临床观察平均值在实际应用中都仅有参考意义。
OBJECTIVE: To evaluate the effect of lens and capsule status on the refractive status of silicone oil filled eyes, and to explore the influencing factors of clinical refraction related to silicon oil filled eyes. Methods: Select the case of silicone oil removal surgery in 69 eyes. Filled silicone oil products are ACRITEC Germany (viscosity 5000cps, refractive index 1.404); silicone oil filled glass chamber volume of about 4/5, under the fundus mirror crescent-shaped interface clearly visible; silicone oil filling time 2-36 months, the average (7.49 ± 6.01) months. 1-3 days before taking the oil for retinoscopy retinoscopy; a few cases for B-ultrasound to understand the intraocular silicone oil bubble shape, location, and the adjacent tissue and so on. 4 weeks after taking oil for routine review of visual acuity, optometry, intraocular pressure, fundus examination. Two times before and after the ophthalmic examination of the refractive error as the amount of change after taking oil refraction. RESULTS: Sixty-nine eyes were divided into three groups: lens group (n = 34), lensless capsule group (n = 22) and lensless capsule group (n = 13). The changes of refraction after taking oil in each group were -9.23 ± 2.82D, 1.09 ± 2.50D and 5.47 ± 2.97D, respectively. There was significant difference between the groups (all P <0.01). Diopter changes in each group were larger individual differences. In the lens group, multivariate linear regression analysis showed that: age, gender, eye, silicone filling time, intraocular pressure within the normal range and other factors have nothing to do with changes in diopter, but with silicone oil refraction before refraction. CONCLUSION: Individuals in each group have significant differences in mean changes in refraction after taking oil from intact and aphakic intact eyes with phacoemulsification. With lens, before and after surgery the diopter changes with age, sex, eye do not, silicone oil filling time, intraocular pressure within the normal range and other factors unrelated, but with silicone oil refraction before surgery. Theoretical derivation parameters or clinical observation of the average value of the practical application of only reference value.