Application of silicone oil tamponade combined with triamcinolone acetonide injection in treatment of complex ocular trauma

Abstract

Objective To investigate the effectiveness of silicone oil tamponade combined with triamcinolone acetonide injection in treatment of complex ocular trauma.Methods The patients with ocular trauma need silicone oil tamponade were randomly divided into 32 eyes joint group of 32 patients and 30 eyes simple group of 30 patients.All the ocular perforation patients underwent debridement suture surgery,then receptive vitrectomy and silicone oil tamponade 1-2 weeks later.All the patients experienced some of following procedures,including lensectomy,foreign body extraction,air-fluid exchange,retinal reattachment with perfluorocarbon liquids or intraocular laser photocoagulation.All patients underwent the conventional standard 3-incision closed vitrectomy.Before injecting silicon oil to vitreous cavity,patients who have experienced lensectomy received iridectomy at 6 point.Triamcinolone acetonide 2 mg injected before incision closure in joint group.Results The incidence of ocular perforation combined with vitreous hemorrhage,endophthalmitis,intraocular foreign body,retinal detachment and cyclodialysis was similar in the two groups (P ＞ 0.05).All the foreign bodies were removed.Postoperative visual acuity was improved 78.5％,unchanged 15.2％,and decreased 6.4％ in joint group,compared with 62.3％,30.3％ and 7.4％ in simple silicone oil fillinggroup (P ＜ 0.05).On the first day postoperative,25.7％ patients in the combination group reported grade 2 or above anterior chamber inflammation,compared with 50.4％ in another group (P ＜ 0.05).Compared with the simple silicone oil filling group,the joint group had a lower rate of proliferative vitreoretinopathy (P ＜ 0.05).The incidence of postoperative high intraocular pressure and retinal redetachment was similar in the two groups (P ＞ 0.05).Conclusions Silicone oil tamponade combined with triamcinolone acetonide injection provides a better effectiveness in treatment of complex ocular trauma. Key words: Silicone oil tamponade ; Triamcinolone acetonide ; Ocular trauma ; Complication