The Study Of Heavy Silicone Oil Treatment Of The Traumatic Retinal Detachment

[Purpose] The purpose of the project experiment was to establish the rabbit model of traumatic retinal detachment,and to investigate the effect of heavy silicone oil treatment of the eye of the rabbits in its each organization structure on the function and morphology as vitreous substitute,then,to evaluate the efficacy and security of heavy silicone oil as vitreous substitute treatment of complicated ocular trauma retinal detachment.[Method] The experiment is divided into two parts.The first part:establishing the rabbit model of ocular trauma which scleral penetrating injury with retinal detachment, and to observe the condition of fundus retinal detachment. Intraocular pressure measurement, ocular B ultrasound, retinal electrophysiological examination and optical microscopy examination performed in all eyes post operation. The second part: Heavy silicone oil,silicone oil or BSS were injected into vitreous cavity of the traumatic retinal detachment model eyes following the pars plana vitrectomy Slitlamp and intraocular pressure measurement and ophthalmoscopy, eye B ultrasonic and electrophysiological examination performed in all eyes post operation regularly.The eyes were observed and enucleated at 4th、8th 12th and 24nd week after surgery respectively for the examination of light microscope, observation of the curative that heavy silicone oil as vitreous substitute treatment of traumatic retinal detachment and its complications and impact on the retina pathology caused by.[Result] Established the rabbit model of traumatic retinal detachment successfully, Compared the b wave amplitude of ERG and the intraocular pressure with preoperative both of them are decreased significantly after model establishment, the light microscopy shown that retinal cone section of rod cells and retinal pigment epithelial cell separation, ganglion cell edema, nuclear migration, cone rod cell falls off and arrange disordered. Heavy silicone oil,silicone oil or BSS were injected into vitreous cavity of the traumatic retinal detachment model eyes. Postoperative all of them had transient ocular inflammatory reaction, cataract, increase of intraocular pressure, but the incidence of difference is no significan. Compared with the three groups of its retinal detachment, except the eyes of BSS group are not completely reset, the other two groups both have 12 eyes were completely reset; The operative eyes of heavy silicone oil group and silicone oil group eyeball atrophy were not discovered, however, the BSS group were occuring different degree of atrophy both in 12 week and 24 week, and as time goes on, atrophy is more serious; The rabbit eyes of retinal visual information transmission function are best in 8 w and 4 w on heavy silicone oil and silicone oil group respectively.Silicone oil group of optical microscopic examination and retina pathological change is more serious than the heavy silicone oil group at each time point, the pathological tissue showed proliferative membranes was fromed on retina when 24 week.[Conclusion] 1、The method of incisioning the rabbit eyes sclera, and extruded its vitreous, then,directly inject in a certain amount of hyaluronic acid sodium (Healon) from the vitreous cavity under the retina by the technology of micro piercing look to establish ocular perforating injury with retinal detachment model of ocular trauma were effective and reliable, simple and practical, good repeatability.2、The effect of postoperative inflammatory reaction in rabbit eyes, intraocular pressure and the chance of concurrency cataract has no obvious difference after heavy silicone oil or silicone oil as intraocular filling treatment of traumatic retinal detachment.3、Heavy silicone oil may be a useful tamponade agent in the inferior retinal detachment which can be well tolerated by retinas as a vitreous substitute within 8weeks,but can result in inconwertibility pathological changes of retinal tissue as long-term tamponade in twelve weeks.And not easy to induce the retina proliferation membrane formation.4 A useful tamponade agent should be used in treating the ocular trauma with retinal detachment in time, retinal reposition and maintain normal intraocular pressure, otherwise, can happen eyeball atrophy, heavy silicone oil or silicone oil tamponade can make the eye to maintain good morphological structures within 24 weeks.