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AIM: To investigate the efficacy of modified silicone oil removal combined with scleral buckling in the treatment of patients with retinal detachment under silicone oil tamponade.METHODS:The retrospective study included a total of 14 patients(14 eyes)who underwent treatment for retinal detachment with silicone oil tamponade at our hospital between January 2021 and February 2023. The modified silicon oil extraction combined with scleral buckling procedure was employed. A self-made 23-gauge suction device was applied in the silicon oil extraction, which involved removing the needle from a disposable blood transfusion set, trimming it to 2.5-3.0 mm near the beveled end, and connecting the other end to a 10 mL syringe without the plunger. The opposite end of the syringe was connected to the negative pressure system of the vitreous cutter to accomplish the silicon oil removal. Scleral compression blocks in scleral buckling surgery using a homemade composite device. No additional silicon oil was injected after the procedure. Follow-up was conducted for 6 mo, assessing retinal reattachment, best-corrected visual acuity(BCVA), intraocular pressure, and complications.RESULTS: At the 6 mo follow-up, the retina was completely reset in 13 eyes, with a retinal reset rate of 93%, and an improvement in BCVA(LogMAR)compared with the preoperative period(0.95±0.18 vs 1.15±0.21, P=0.002). Transient high IOP occurred in 6 eyes at 1 d postoperatively and returned to normal after medication control. There were no intraoperative complications such as retinal hemorrhage, retinal incarceration, or iatrogenic retinal breaks, and no postoperative complications such as endophthalmitis or choroidal detachment.CONCLUSIONS:Modified silicone oil removal combined with scleral buckling can effectively treat retinal detachment in the silicone oil tamponade and induce retinal reattachment.
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AIM: To compare the outcome of C3F8 versus silicone oil tamponade after pars plana vitrectomy(PPV)and inverted internal limiting membrane(ILM)for the treatment of highly myopic macular hole retinal detachment(MHRD).METHODS: Retrospective clinical study. Totally 45 patients(45 eyes)with highly myopic MHRD who visited our hospital between January 2019 and August 2022 were selected as the research subjects. The patients were divided into two groups according to different intraocular tamponade agents: C3F8(22 eyes)and silicone oil(23 eyes)groups. All patients underwent conventional three-incision PPV, ILM was tamped, a venous blood clot was placed on the tamped ILM, and 15% C3F8 and silicone oil were used as tamponade, respectively. The best corrected visual acuity(BCVA), multifocal electroretinogram(mfERG), the closure of the macular hole, retinal reattachment and the complications were observed.RESULTS: The macular hole closure rate was 77% in the C3F8 group and 83% in the silicone oil group, respectively(P>0.05), and retinal reattachment rates were 95% and 96%, respectively(P>0.05). The visual acuity of the two groups significantly improved, which was 0.99±0.34 and 1.22±0.37, respectively, and the C3F8 group was better than that of the silicone oil group(t=-2.156, P=0.037). After operation, the response density of the first ring of P1 wave in the first order kernel in mfERG was 114.27±26.37 nV/deg2 for the C3F8 group and 98.08±24.36 nV/deg2 for the silicone oil group, and the response density of the second ring of P1 wave was 80.45±14.94 nV/deg2 for the C3F8 group and 67.73±15.33 nV/deg2 for the silicone oil group, all of which were significantly higher compared to pre-operation [the response density of the first ring of P1 wave: 58.13±13.96 nV/deg2 for the C3F8 group and 55.30±10.48 nV/deg2 for the silicone oil group, the response density of the second ring of P1 wave: 51.18±8.19 nV/deg2 for the C3F8 group and 47.43±11.97 nV/deg2 for the silicone oil group](all P<0.05). It was found that the response density of the first ring of P1 wave was lower in the silicone oil group than in the C3F8 group(P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).CONCLUSION: Silicone oil tamponade or C3F8 tamponade after PPV combined with ILM can both promote retinal reattachment and macular hole closure in patients with MHRD, and the C3F8 tamponade was superior to silicone oil in visual function recovery.
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Purpose: To derive a formula for accurate axial length (AL) assessment using routine ultrasound in silicone oil?filled eyes, where optical biometry is unavailable or not possible. Methods: This was a prospective, consecutive, nonrandomized study of 50 eyes of 50 patients conducted in a tertiary care hospital in North India. AL measurements were taken using both manual A?scan and IOL master, both in silicone oil?filled status and 3 weeks after silicone oil removal. A correction factor of 0.7 was used for AL adjustment in oil?filled eyes. The corrected AL (cAL) was compared with IOL master values in oil?filled eyes. Agreement analysis was carried out using Bland Altman plot. Linear regression analysis was done using uncorrected manual AL to find a new equation. Data was analyzed using Stata 14. A P value <0.05 was taken as significant. Results: The study included 40 males and 10 females, with an age range of 6–83 years (mean 41.9 years). The mean AL of the oil?filled eye as measured by manual A?scan was 31.76 mm ± 3.09 and by IOL master was 24.7 mm ± 1.74. Linear regression analysis was performed in randomly selected 35 eyes of the observed data to obtain a new equation: predicted AL (PAL) = 14 + 0.3 × manual AL. The mean difference between PAL and optically measured AL with silicone oil in situ was 0.98 ± 1.67. Conclusion: We propose a new formula for better prediction of the correct AL in silicone oil?filled eyes using ultrasound?based AL measurement.
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ABSTRACT Purpose: To compare viscotrabeculotomy with anterior chamber irrigation to Ahmed glaucoma valve implantation for secondary glaucoma following silicone oil removal. Methods: A prospective study was conducted on 43 vitrectomized pseudophakic eyes with persistent glaucoma after silicone oil removal. Patients were randomized to either viscotrabeculotomy with anterior chamber irrigation or Ahmed glaucoma valve implantation. All patients were examined on day 1, week 1, and months 1, 3, 6, 9, 12, 18, and 24 postoperatively. Postoperative complications were noted. Success was defined as an intraocular pressure between 6 and 20 mmHg and with an intraocular pressure reduction of >30% compared with the preoperative intraocular pressure. Results: There were 22 eyes in the viscotrabeculotomy with anterior chamber irrigation and 21 eyes in the Ahmed glaucoma valve implantation group. The mean preoperative and postoperative intraocular pressure in the viscotrabeculotomy with anterior chamber irrigation and Ahmed glaucoma valve implantation groups were 35.5 ± 2.6 mmHg and 35.5 ± 2.4 mmHg and 16.9 ± 0.7 mmHg and 17.9 ± 0.9 mmHg respectively (p˂0.0001). There was a statistically significant intraocular pressure reduction at all follow-up time points compared to preoperative values (p˂0.0001) in both groups. The unqualified success rate in the viscotrabeculotomy with anterior chamber irrigation and Ahmed glaucoma valve implantation groups were 72.73% and 61.9%, respectively. A minimal self-limited hyphema was the most common complication. Conclusions: Both viscotrabeculotomy with anterior chamber irrigation and Ahmed glaucoma valve implantation are effective in lowering the intraocular pressure in glaucoma after silicone oil removal with viscotrabeculotomy with anterior chamber irrigation providing greater reduction, higher success rates, and minimal complications.
RESUMO Objetivo: Comparar a viscotrabeculotomia com irrigação da câmara anterior com o implante de válvula de glaucoma de Ahmed para glaucoma secundário após remoção de óleo de silicone. Métodos: Foi realizado um estudo prospectivo de 43 olhos pseudofácicos vitrectomizados com glaucoma persistente após a remoção de óleo de silicone. Os pacientes foram randomizados para viscotrabeculotomia com irrigação da câmara anterior ou implante de válvula de Ahmed. Todos os pacientes foram examinados no primeiro dia, na primeira semana e 1, 3, 6, 9, 12, 18 e 24 meses após a cirurgia. Observaram-se complicações pós-operatórias. O sucesso foi definido como uma pressão intraocular entre 6 e 20 mmHg e uma redução da pressão intraocular >30% em comparação com a pressão intraocular pré-operatória. Resultados: Foram designados 22 olhos para o grupo da viscotrabeculotomia com irrigação da câmara anterior e 21 olhos para o grupo do implante de válvula de Ahmed. A pressão intraocular média pré-operatória foi de 35,5 ± 2,6 mmHg para o grupo da viscotrabeculotomia com irrigação da câmara anterior e pós- e de 35,5 ± 2,4 mmHg no grupo do implante de válvula de Ahmed. e Os valores pós-operatórios foram de 16,9 ± 0,7 mmHg e 17,9 ± 0,9 mmHg para esses mesmos grupos, respectivamente (p<0,0001). Ambos os grupos tiveram uma redução estatisticamente significativa da pressão intraocular em relação aos valores pré-operatórios (p<0,0001) em todos os momentos do acompanhamento. A taxa de sucesso não qualificado nos grupos da viscotrabeculotomia com irrigação da câmara anterior e do implante de válvula de Ahmed foi de 72,73% e 61,9%, respectivamente. A complicação mais comum foi o hifema, autolimitado e mínimo. Conclusões: Tanto a viscotrabeculotomia com irrigação da câmara anterior quanto o implante de válvula de Ahmed são eficazes na redução da pressão intraocular no glaucoma após injeção de óleo de silicone, mas a viscotrabeculotomia com irrigação em câmara anterior proporcionou maior redução da pressão intraocular e maiores taxas de sucesso, com complicações mínimas.
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Purpose: Our aim was to determine the various risk factors for secondary ocular hypertension (OHT) following pars plana vitrectomy (PPV) with silicone oil (SO) injection. Methods: A prospective cohort study was performed on 46 eyes of 42 patients who underwent PPV with SO injection under a single surgeon between January 2020 and July 2021. Complete ophthalmological examination including gonioscopy and Goldmann applanation tonometry was performed preoperatively and on three postoperative visits, that is, day 7, day 30, and day 90. Axial length and lens thickness were measured at baseline using immersion A?scan. Anterior segment optical coherence tomography (OCT) was used for measuring anterior chamber depth (ACD) at baseline and at 3 months. Results: There was a statistically significant increase in intraocular pressure (IOP) (>21 mmHg) on day 7 (4.70 ± 7.754 mmHg), day 30 (5.24 ± 7.481 mmHg), and day 90 (2.39 ± 5.659 mmHg) (P<0.01 for all). Age <50 years, rhegmatogenous retinal detachment (RRD), and pseudophakia had a strong association with short?term OHT on day 7. Preexisting glaucoma was the only independent risk factor for long?term OHT (day 90). Higher baseline IOP and SO emulsification also contributed to long?term OHT. Conclusion: There was a statistically significant elevation in IOP at all postoperative visits. Short?term OHT was associated with younger age (<50 years), RRD, and pseudophakia. Patients with emulsified SO in the anterior chamber, higher baseline IOP, and preexisting glaucoma were at higher risk for long?term OHT.
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AIM: To observe the clinical effect of foldable capsular vitreous body(FCVB)implantation on ocular trauma and silicone oil-dependent eyes.METHODS: A prospective case study was performed on 17 cases(17 eyes)with ocular trauma and silicone oil-dependent in the First Hospital of Changsha from October 2017 to April 2022. All patients underwent FCVB or silicone oil removal combined with FCVB implantation. The follow-up time was 6mo, and the visual acuity, intraocular pressure, ocular axes, normal external appearances and FVCB were observed at 1wk and 6mo after operation.RESULTS: Only 6 cases had visual acuity before operation, and there were no statistical differences in the visual acuity before and at 1wk and 6mo after operation(P>0.05). The intraocular pressure was low before operation, but it was elevated at 1wk and 6mo after operation. The axial length was unchanged at 1wk and 6mo after operation, and the appearance and structure of eyeball were well maintained, and FCVB was stable with no atrophy during the follow-up period.CONCLUSIONS: FCVB implantation can preserve the appearance of eyeball, and avoid atrophy of eyeball and repeated operation, which has favorable clinical application value in the treatment of ocular trauma and silicone oil-dependent eyes.
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Objective@#This small case series demonstrated pars plana vitrectomy and silicone tamponade without internal limiting membrane (ILM) peeling to be a simple, safe, and effective surgical technique for the treatment of myopic traction maculopathy (MTM).@*Methods@#This is a small case series consisting of 3 eyes with MTM. In all eyes, pars plana vitrectomy with silicone oil tamponade was performed by a single vitreoretinal surgeon. Functional and anatomic outcomes are reported.@*Results@#All 3 eyes had improved visual acuity with no noted short-term complications such as iatrogenic macular hole and retinal detachment. Although foveoschisis was only partly anatomically resolved in 2 out of the 3 cases, functional outcome, in terms of visual acuity at last visit, was satisfactory.@*Conclusion@#Vitrectomy with silicone oil tamponade without ILM peeling is a simple, effective, and safe optional surgical technique to treat MTM.
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La silicona líquida es usada intravítrea cuando se requiere un taponamiento prolongado intraocular para mantener la retina aplicada. A pesar de sus ventajas, su uso se ha asociado a algunas complicaciones como catarata, queratopatía, hipertensión ocular, glaucoma entre otras. La hipertensión ocular secundaria por aceite de silicona aparece por varios mecanismos, la migración de partículas a la malla trabecular junto con el proceso inflamatorio que genera es un reto para los cirujanos, de ahí los diferentes criterios de tratamiento que existen para su completa resolución. A continuación, se presenta un paciente operado de desprendimiento de retina recidivado con hipertensión ocular secundario a aceite de silicona 9 meses después de su primera intervención. Llevó tratamiento con hipotensores oculares tópicos, orales y no resolvió por lo que se decide realizar ciclocrioterapia en dos cuadrantes. A pesar que este tratamiento no es el de elección en estos casos, podemos decir que en este paciente se logra controlar la presión intraocular luego de una sola sesión(AU)
Liquid silicone is used intravitreally when prolonged intraocular insulation is required to keep the retina applied. Despite its advantages, its use has been associated with some complications such as cataract, keratopathy, ocular hypertension, glaucoma, among others. Secondary ocular hypertension due to silicone oil appears by several mechanisms. The migration of particles to the trabecular meshwork, together with the inflammatory process it generates, represents a challenge for surgeons, hence the different treatment criteria that exist for its complete resolution. The following is a patient operated on for recurrent retinal detachment with ocular hypertension secondary to silicone oil 9 months after the first operation. He was treated with topical and oral ocular hypotensors and it did not resolve, so it was decided to perform cyclocriotherapy in two quadrants. Although this treatment is not the treatment of choice in these cases, we can say that in this patient intraocular pressure control was achieved after only one session(AU)
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Humans , Cataract/complications , Silicone Oils/therapeutic use , Retinal Detachment/etiology , Ocular Hypertension , Glaucoma/complicationsABSTRACT
Purpose: To compare the axial length (AL) obtained by A-scan biometry (PAC SCAN 300AP; Sonomed Escalon, USA) and LENSTAR-LS 900 (Haag-Streit, Koeniz, Switzerland) in silicone oil (SiO)-filled eyes. Methods: AL measurements were taken in 50 SiO-filled eyes using A-scan and LENSTAR-LS 900 before SiO removal and 1 month following SiO removal. In the subset of patients requiring intraocular lens (IOL) insertion, the predicted refraction and the refraction obtained were compared. IOL power in these patients was calculated using SRK-T formula and the AL obtained by LENSTAR. Results: In SiO-filled eyes, a significant difference was noted between the AL values obtained using the two methods (P = 0.0002). No significant difference was noted after SiO removal (P = 0.634). In the subset of patients needing IOL insertion, no significant difference (P = 0.07) was seen between target refractive error and postoperative refractive error (mean deviation from the target being 0.176 diopter). AL of an SiO-filled eye is more accurately measured using optical low coherence reflectometry (OLCR)-based biometry (LENSTAR) than with conventional acoustic biometry (A-scan). Conclusion: We conclude that LENSTAR gives more accurate biometry in an SiO-filled eye. The AL obtained after SiO removal was comparable and showed no significant difference
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Purpose: To analyze the anatomical and visual outcomes of microincision vitrectomy surgery (MIVS) with silicone oil tamponade in eyes having coloboma?related retinal detachment (RD) and evaluate the risk factors for recurrence of RD. Methods: This was a retrospective, multicentric analysis of eyes having coloboma RD undergoing MIVS with silicone oil tamponade between March 2010 and July 2018. Results: We evaluated 148 eyes of 144 patients. The mean age of presentation was 17.4 ± 9.8 years (range: 2–65 years) and the mean follow?up duration was 13.1 ± 13.8 months (range: 3–84 months). The single operation success rate was 88.5% (131 eyes), with an overall successful outcome achieved in 90.5% (134 eyes). Recurrence of RD occurred in 17 eyes (11.5%) over a mean duration of 2.59 ± 3 months. The risk of recurrence was found to be higher in eyes where relaxing retinectomy (RR) was performed (odds ratio [OR]: 3.22; P = 0.05). A statistically significant improvement in vision was noted in the majority of cases from logMAR 1.85 ± 0.34 preoperatively to logMAR 1.33 ± 0.6 post?surgery (P = 0.002). Conclusion: MIVS with silicone oil tamponade provided an anatomical success rate of 90.5% in eyes with coloboma RD with a significant improvement in visual acuity. Eyes in which RR was performed were susceptible to higher rates of re?detachment.
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The presence of emulsified silicone oil in the eye can lead to many complications, glaucoma being one of the most common. Adequate IOP control is difficult to achieve with medical management alone; surgical intervention is often required. Glaucoma drainage device implantation is often the preferred line of surgical intervention in such cases due to trabeculectomy failure from emulsified silicone oil droplets and associated conjunctival scarring. However, the silicone tube of Ahmed glaucoma valve (AGV) may attract the silicone oil droplets, causing blockade of the tube with persistent raised IOP postoperatively. We report one such case where post?AGV silicone oil tube occlusion was treated with semi?conservative surgical management instead of revising the entire surgery or implantation of another drainage device. Our surgical technique of intracameral “vent and flush” offers rapid and effective IOP control in such cases. Postoperatively, normal IOP was achieved. Patency of tube continued to be maintained along with normalization of IOP on subsequent follow?ups.
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The classical surgical operations for foveoschisis in high myopia are vitrectomy, artificial posterior vitreous detachment, removal of the pre-macular vitreous cortex, removal of the inner limiting membrane (ILM) and intraocular gas tamponade, with some minor variations on those basis, including no removal of the ILM or ILM peeling with preservation of the fovea area; with or without gas filling, long-term silicone oil tamponade, etc. All the procedures have achieved certain efficacy and the foveoschis can be fully or partially relieved and the visual acuity can be improved to different degrees. It is worthwhile to emphasize, the most common and serious complication of the surgery is the occurrence of full-thickness macular hole or even postoperative macular hole retinal detachment. To address the risk of such complications, a safe and effective outcome can be achieved in the majority of cases by using ILM peeling with preservation of the fovea area. For high-risk cases where the operator is concerned about intraoperative or postoperative macular hole, a long-term silicone oil tamponade without ILM removal is proposed to prevent the risk of surgery-related macular hole formation.
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The classical surgical operations for foveoschisis in high myopia are vitrectomy, artificial posterior vitreous detachment, removal of the pre-macular vitreous cortex, removal of the inner limiting membrane (ILM) and intraocular gas tamponade, with some minor variations on those basis, including no removal of the ILM or ILM peeling with preservation of the fovea area; with or without gas filling, long-term silicone oil tamponade, etc. All the procedures have achieved certain efficacy and the foveoschis can be fully or partially relieved and the visual acuity can be improved to different degrees. It is worthwhile to emphasize, the most common and serious complication of the surgery is the occurrence of full-thickness macular hole or even postoperative macular hole retinal detachment. To address the risk of such complications, a safe and effective outcome can be achieved in the majority of cases by using ILM peeling with preservation of the fovea area. For high-risk cases where the operator is concerned about intraoperative or postoperative macular hole, a long-term silicone oil tamponade without ILM removal is proposed to prevent the risk of surgery-related macular hole formation.
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AIM:To evaluate the macular microstructural changes in patients with rhegmatogenous retinal detachment(RRD)after silicone oil tamponade by spectral-domain optical coherence tomography(SD-OCT).METHODS:From November 2019 to July 2021, 27 patients with 27 eyes in RRD who underwent vitrectomy combined with silicone oil tamponade in Cangzhou Aier Eye Hospital were enrolled in this study as the observation group, other 30 healthy volunteers with 30 eyes were included in the control group. The best corrected visual acuity(BCVA)of patients before and after operation were observed, and quantified evaluation of the postoperative macular microstructural changes were performed by SD-OCT.RESULTS: The BCVA(LogMAR)of the observation group at 1wk and 3mo after operation(0.61±0.23, 0.69±0.34)were improved compared with those before operation(1.43±0.77)(all P<0.01). The cube volume and average cube thickness in the macular area at 3mo after operation in the observation group were lower than those at 1wk and 1mo after operation in the control group(all P<0.05). There were no differences in the average ganglion cell-inner plexiform layer(GCIPL)thickness, minimum GCIPL thickness, average macular retinal nerve fiber layer(mRNFL)thickness and minimum mRNFL thickness at 1wk, 1 and 3mo after operation in the observation group, but all decreased compared with the control group(all P<0.01). There were 9 eyes with subretinal fluid(SRF)in the observation group during postoperative follow-up, SRF had a tendency to be gradually absorbed, but 1 eye had a secondary macular hole; 3 eyes had ellipsoid zone disruption, which had a tendency to be gradually repaired; 2 eyes had submacular perfluorocarbon liquid; 2 eyes had macular edema.CONCLUSION: SD-OCT can show the microstructure and morphological changes very well in macular area in patients with RRD after silicone oil tamponade, and has important clinical value for the preoperative and postoperative follow-up evaluation of RRD.
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@#AIM: To investigate the clinical effect of posterior capsulotomy in diabetic retinopathy with silicone oil removal combined with cataract surgery.<p>METHODS: A retrospective analysis that collected clinical data of 83 cases(83 eyes)diagnosed as diabetic retinopathy and silicone oil filled eyes with cataract and treated in our hospitalfrom January 2019 to February 2020. They were randomly divided into two groups. The experimental group consisted 41 eyes received silicone oil removal and posterior capsulotomy combined with cataract surgery; The rest 42 eyes were in control group, who received silicone oil removal combined with cataract surgery. At 6mo after surgery, the best corrected visual acuity, posterior capsular opacification, and floaters were evaluated between the two groups to confirm the advantages of posterior capsulotomy in combined cataract surgery with silicone oil removal for diabetic retinopathy.<p>RESULTS: At 6mo after surgery, the best corrected visual acuity in experimental group was better than control group(<i>P</i><0.05); There were significant differences between the two groups in the posterior capsular opacification, and floaters,experimental group is lower than control group(<i>P</i><0.05). There was no significant difference in intraocular pressure compared to preoperative between the two groups, and no significant difference in retinal detachment, vitreous hemorrhage and intraocular lens deviationafter operation(<i>P</i>>0.05). <p>CONCLUSION: Posterior capsulotomy is safe and reliable in the application of silicone oil removal combined with cataract surgery for diabetic retinopathy, and can effectively avoid the occurrence of posterior capsular opacification.
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Objective:To investigate the cleaning status of silicone oil attached ophthalmic surgical instruments in China, so as to provide reference and suggestions for the standard cleaning process of silicone oil attached ophthalmic surgical instruments.Methods:61 hospitals in 22 provinces (regions, municipality) in China were selected as the objects of investigation. The on-site treatment, pretreatment and routine cleaning of silicone oil attached ophthalmic surgical instruments were investigated by questionnaire from November 2019 to January 2020.Results:18.033% (11/61) hospitals had mixed silicone oil attached ophthalmic surgical instruments and other instruments intraoperatively, 11.475% (7/61) hospitals didn′t wipe silicone oil and other visible contaminants postoperatively. 18.033% (11/61) hospitals didn′t carry out pretreatment and 4.000% (2/50) hospitals used saline as pretreatment solution; 54.098% (33/61) hospitals were involved in ultrasonic cleaning. 32.787% (20/61) hospitals had water temperature 31-37 ℃ and 4.918% (3/61) hospitals had water temperature>37 ℃during the cleaning process; During pretreatment and routine cleaning, 38.000% (19/50) hospitals and 54.902% (28/51) hospitals selected enzymatic detergent respectively, the contact time between instruments and detergent in specialized hospital was more standardized than that in general hospital ( P<0.001); In flushing, rinsing and final rinsing, there were 29.412% (15/51) hospitals, 11.765% (6/51) hospitals and 3.922% (2/51) hospitals used water that didn′t meet the requirements. 17.647% (9/51) hospitals, 13.725% (7/51) hospitals and 13.725% (7/51) hospitals didn′t record the time of flushing, rinsing and final rinsing. Conclusions:There are still some problems in the cleaning of silicone oil attached ophthalmic surgical instruments in specialized and general hospitals, such as no on-site treatment and pretreatment, improper control of cleaning parameters, and difficulty in ensuring water quality and water time. It is necessary to formulate the cleaning process specification of silicone oil attached ophthalmic surgical instruments as soon as possible to ensure the cleaning quality and avoid the occurrence of postoperative eye complications.
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@#AIM: To explore the postoperative axial length(AL)and corneal curvature(K)shift in high myopia silicone oil patients complicated cataract after silicone oil removal combined with cataract surgery as well as the relationship.<p>METHODS: From August 2020 to November 2020 in the Affiliated Eye Hospital of Nanchang University, 45 patients(48 eyes)with silicone oil eye complicated cataract were divided into 2 groups: 20 eyes of 20 patients(refraction ≥-6.00D and AL ≥26mm)in high myopia group and 28 eyes of 25 patients(refraction < -6.00D or AL <26mm)in non-high myopia group. Record the general information and IOL-Master measurement data AL and K, statistical analysis was performed. <p>RESULTS: There was no difference in preoperative and postoperative K value of two groups(all <i>P</i>>0.05). The AL of the patients in the high myopia group was 28.35±1.68mm after silicone oil removal combined with cataract surgery, which was shorter than 28.08±1.53mm before the operation(<i>P</i><0.001), yet not statistically significant in non-high myopia group(<i>P</i>>0.05). The median ΔAL of patients in the high myopia group was \〖-0.28(-0.44, -0.08)\〗 compared with the non-high myopia group \〖-0.06(-0.20, 0.15)\〗, which was statistically different(<i>P</i><0.05), but no significant difference in both ΔK(<i>P</i>>0.05). There was no correlation between |ΔAL| and |ΔK|, or and preoperative K values(<i>P</i>>0.05)in two groups. Preoperative AL was moderately positive correlated with |ΔAL| in the high myopia group(<i>r</i>=0.702, <i>P</i>=0.01), but not in the non-high myopia group(<i>P</i>>0.05).<p>CONCLUSION: There was no significant shift in K value of high myopia group with silicone oil eye complicated cataract after the silicone oil removal combined with cataract surgery. The longer preoperative AL in high myopia group, the more likely become shorter after surgery, meanwhile the longer AL, the greater AL shift.
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The incidence of endophthalmitis after vitrectomy is extremely low,especially lower in silicone oil-filled eyes.Silicone oil exerts a toxic effect on the cell membranes of microorganisms and leads to the lack of nutrients.It is thus believed to inhibit the growth of bacteria and fungi.Endophthalmitis induced by mixed bacteria in silicone oil-filled eye has been rarely reported.We reviewed the clinical manifestations,diagnosis,and treatment of a patient with endophthalmitis caused by mixed infection of
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Humans , Bacteria , Coinfection , Endophthalmitis , Silicone Oils/adverse effects , VitrectomyABSTRACT
@#AIM: To explore the postoperative refractive error and influence factors using the Optical Biometry(IOL Master)in patients with silicone oil filled eye complicated cataract after silicone oil removal combined with cataract surgery.<p>METHODS: From August 2020 to November 2020 in the Affiliated Eye Hospital of Nanchang University, 41 patients with silicone oil removal combined with cataract surgery were divided into 2 groups: 18 patients(18 eyes)in high myopia group and 23 patients(23 eyes)in non-high myopia group. Collected and recorded the patients' IOL Master measurement data. Statistical analysis was performed in SPSS20.0.<p>RESULTS: The mean spherical degree or astigmatism of the IOL Master measurement and refraction in high myopia and non-high myopia group performed by paired <i>t</i>-test(<i>P</i>>0.05). The mean axial difference ΔAL were -0.28±0.29 and 0.05±0.31mm between the two groups has no difference(<i>P</i><0.05), while ΔK, mean absolute refractive error(MARE)and Δastigmatism(<i>P</i>>0.05). The preoperative and postoperative axial length(AL)in high myopia groups were 28.37±1.73 and 28.10±1.55mm(<i>t</i>=3.994, <i>P</i><0.05), yet the non-high myopia group(<i>P</i>>0.05). Bivariate linear correlation analysis: in the high myopia group, there was a moderate positive correlation between preoperative AL and MARE(<i>r</i>=0.742, <i>P</i><0.05), and a moderate negative correlation between ΔAL and MARE(<i>r</i>=-0.646, <i>P</i><0.05), but in non-high myopia group, preoperative AL, ΔAL, preoperative K, ΔK had no correlation(<i>P</i>>0.05).<p>CONCLUSION: IOL Master performed the small biostatistical error and high measurement accuracy of the intraocular lens in patients with silicone oil filled eye complicated cataract. The longer preoperative AL, the more changes in the axial length after silicone oil removal, and the greater the refractive error of patients with high myopia silicone oil filled eye complicated cataract.
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@#AIM: To explore the efficacy and safety of foldable capsular vitreous body(FCVB)in the treatment of severe ocular trauma and silicone oil dependent eyes.<p>METHODS:A retrospective study. Totally 20 patients who were underwent FCVB implantation due to severe ocular trauma and silicone oil reliance conducted in our hospital from May 2018 to October 2019 were select as observation group, 10 previous severe eye trauma patients without FCVB implantation as control group. The visual acuity(VA), intraocular pressure(IOP), exophthalmos, eye axis length, retinal reattachment, and complications of preoperative and postoperative in observation group and control group were recorded. A 1a follow-up was carried out to compare the changes in the observation indicators of each group so as to evaluate the effectiveness and safety of the FCVB.<p>RESULTS: Before and 1a after operation, there were no statistically significant differences in VA, eyeball protrusion, and axial length of the observation group, but IOP was significantly increased. The preoperative eyeball protrusion and axial length of the control group were larger than those of the observation group, but they were smaller than those of the observation group during the 1a follow-up. The eyeball protrusion and axial length of the control group were also significantly reduced 1a after the operation compared with the preoperative baseline. Retinas were well attached, silicone oil emulsification, secondary glaucoma, endophthalmitis and any other severe adverse event were not even occurred in the observation group.<p>CONCLUSION:FCVB could effectively and safely prevent eyeball atrophy in the treatment of severe eye trauma and silicone oil dependent eyes.