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摘要: 針對傳統醫療手段無法有效量化評估手術中不同硅油加注量對于視網膜裂孔貼附效果的問題，本文提出一種面向視網膜脫離手術的硅油填充模擬方法，基于物理建模與計算機數值離散化技術對眼內受力、硅油填充狀態進行分析，并對填充模擬過程進行三維模型構建與可視化，實現醫療過程決策輔助目的。首先對人類眼球與手術器具進行基礎建模與模型采樣，模擬手術流程中眼球狀態；然后，根據水與硅油的密度、黏滯系數、表面張力等不同物理性質，對水?硅油兩相流動及交互進行模擬；最后，構建固液交互模型，實現多相液體在眼球中的運動與填充。實驗結果表明，本文方法能夠較好地呈現眼球內多相流體運動交互效果，實現了諸如表面張力、固液耦合、液體分層、連通器效應等效果，實現了對眼內腔中通過導管注入硅油與排出水分流程的模擬，為預測硅油填充后的眼內狀態提供了一種有效的方式，輔助醫生進行手術流程規劃與效果預測。Abstract: With advancements in modern medical technology, the treatment of rhegmatogenous retinal detachment has been receiving increasing attention. Globally, vitrectomy combined with intraocular silicone oil tamponade has been widely used for rhegmatogenous retinal detachment, and the surgical equipment and technology required are increasingly advanced. In such an operation, it is crucial to understand how to achieve the best therapeutic effect with the minimum amount of silicone oil tamponade so as to reduce surgical complications. Traditional medical methods cannot effectively evaluate the effect of different silicone oil dosages on retinal hole attachment. Aiming at this concern, the current study proposed a silicone oil tamponade simulation method for retinal detachment surgery. Based on physical modeling and computer numerical discretization techniques, the intraocular force and silicone oil filling state were analyzed. Three-dimensional modeling and simulation of the silicone tamponade process were then conducted and visualized to help with medical decision-making. First, the human eyeball and surgical instruments were modeled and sampled to simulate the eyeball state during the operation. Second, based on differences in density, viscosity coefficient, and surface tension between water and silicone oil, the two-phase flow and water?silicone oil interaction were simulated. Finally, the solid?liquid interaction model was constructed to assess the movement and injection process of multiphase liquid in the eyeball. The experimental results show that this method can well present the interaction effect of multiphase fluid movement in the eyeball; understand effects such as surface tension, solid–liquid coupling, liquid stratification, and connector effect; and realize the simulation of the silicone oil injection and water drainage processes through the catheter in the intraocular cavity, which provides an effective way to predict the intraocular state after silicone oil filling and assists doctors in the field of operation process planning and effect prediction.
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圖 1 孔源性視網膜脫離（a）與正常眼底照相（b）
Figure 1. Photographs of rhegmatogenous retinal detachment (a) and normal fundus (b)
圖 2 玻璃體切割聯合硅油填充術示意圖。（a）孔源性視網膜脫離；（b）硅油眼內填充
Figure 2. Schematic diagram of vitrectomy combined with silicone oil tamponade: (a) rhegmatogenous retinal detachment; (b) silicone oil tamponade
圖 3 孔源性視網膜脫離治療建模分析流程圖
Figure 3. Modeling and analysis flow chart of rhegmatogenous retinal detachment
圖 4 SPH方法下粒子數值近似示意圖
Figure 4. Numerical approximation of particles using smoothed particle hydrodynamics method
圖 6 兩相流潰壩實驗。（a～d）流體運動過程粒子狀態；（e～h）渲染后效果
Figure 6. Dam break experiment of two-phase flow: (a–d) particle state of fluid motion; (e–h) post-render effect
圖 7 不同張力系數下的水塊沖擊表現結果。（a～d）第22幀時
$\alpha = 0,\;0.1,\;0.5,\;0.8$ 的效果；（e～h）第69幀時$\alpha = 0,\;0.1,\;0.5,\;0.8$ 的效果；（i～l）第503幀時（靜止后）$\alpha = 0,\;0.1,\;0.5,\;0.8$ 的效果Figure 7. Impact performance of water blocks with different tension coefficients: (a–d) effect at frame 22 when
$\alpha = 0,\;0.1,\;0.5,\;0.8$ ; (e–h) effect at frame 69 when$\alpha = 0,\;0.1,\;0.5,\;0.8$ ; (i–l) effect at frame 503 (after rest) when$\alpha = 0,\;0.1,\;0.5,\;0.8$ 
圖 8 不同張力系數下液體表面積變化率
Figure 8. Rate of liquid surface area change under different tension coefficients
圖 9 眼球內兩相液體交互。（a～c）第266幀兩相均無表面張力、只有硅油具有表面張力、兩相均有表面張力時的交互情況；（d～f）第376幀兩相均無表面張力、只有硅油具有表面張力、兩相均有表面張力時的交互情況
Figure 9. Two-phase liquid interaction in the eyeball: (a–c) interaction effect of the two phases without surface tension, only the surface tension of silicone oil, and the surface tension of both phases in frame 266; (d–f) interaction effect of the two phases without surface tension, only the surface tension of silicone oil, and the surface tension of both phases in frame 376
圖 10 硅油填充手術流程模擬：硅油順導管注入并排出眼內水的流程
Figure 10. Simulation of silicone oil tamponade: flow of silicone oil injection and discharge of water from the hole along the guide tube
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