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Background The ultrasonography for silicone tamponade eye is a problem in diagnosis and treatment of eye diseases,especially for the calculation of intraocular lens (IOL) power.IOL Master is usually used to the biometric measurement of the silicone tamponade eye in well-equipped hospital,but it is still disabled in serious cataractous eyes.Corrective B or A-type ultrasound methods have been used for a fewer years,but these measured results are incomparable probably due to the difference of viscosity of silicone oils.Objective This study attempted to investigate the accuracy of B-type ultrasonography for ocular axial length (AL) measurement in silicone tamponade eyes.Methods The transmitting speed of ultrasonic wave in the silicone oil was determined by comparing the outcomes between balance solution mesuring and 5 500 mPas silicone oil,and a calculating formula for corrective ocular AL in 5 500 mPas silicone filled eyes was further established.Thirty-two eyes of 30 patients who received 5 500 mPas silicone oil tamponade due to complex retinal detachment were enrolled in Qingdao Hiser Medical Group from May 2012 to March 2014.The eyes were assigned to the AL＜26 mm group (18 eyes of 16 patients) and AL≥26 mm group (14 eyes of 14 patients).B-scan ultrasound and IOL Master were used to measure the AL before the removal of the silicone oil,and the Als were measured again using A-scan ultrasound and B-scan ultrasound 3 months after the removal of the silicone oil.The outcomes were compared and the correlations were evaluated among different measuring methods.The vitrous length values before and after removal of the oils,and the diopters before and after intraocular pressure (IOP) implantation were compared to varify the results of B-type sonography for 5 500 mPas silicone-tamponade eyes.Results The transmitting speed of sound wave in 5 500 mPas silicone oil was 1 023 m/second with the conversion factor 0.668 between silicon oil eyes and vitreous cavity,and the corrected formula for AL measurement was:the length form cornea apex to the posterior pole of lens or the center of the capsular membrane+ 0.668×the length form posterior pole of lens or the center of the capsular membrane to the macular area.No significnant differences were found in the AL values among the corrective-B scan,IOL Master method,postoperative Bscan method and A-scan method both in the AL＜26 mm group and the AL≥26 mm group (AL＜26 mm:F=0.108,P =0.955;AL ≥ 26 mm:F =0.011,P =0.998),and the AL values by corrective B-scan was significantly correlated with that by IOL Master,postoperative B-scan and A-scan,respectively (AL＜26 mm group:r =0.876,0.921,0.809,all at P＜0.01;AL ≥ 26 mm group:r =0.943,0.956,0.955,all at P＜0.01).The vitreous cavity depth was (20.78 ±2.13)mm by corrective B-scan in 1 day before the removal of silicone,and that in 3 months after removal of silicone was (20.89±2.16) mm,without statistical diference between them (t =0.795,P =0.219).The actual postoperative refraction in 16 eyes with IOL was (-1.25 ± 1.69) D,and preoperative refrection was (-1.50 ±0.00) D,the difference was not statistically significant (t =0.585,P =0.284).Conclusions The biometry of B-scan ultrasonography for silicone-tamponade eye is accurate and simple,with a good feasibility in clinical measurement.
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Objective To compare the effects of intravitreal tamponade of C3 F8 with silicon oil on postoperative vitreous hemorrhage and visual prognosis after vitrectomy for proliferative diabetic retinopathy (PDR).Methods The clinical data of 121 patients (127 eyes)who underwent primary vitrectomy due to PDR were analyzed retrospectively.All the patients were divided into two groups according to different intravitreal tamponade, including C3 F8 tamponade group (53 patients with 56 eyes ) and silicone oil tamponade group (68 patients with 71 eyes).There was no difference of gender (χ2 = 0.956 ),age (t =1.122),duratiion of diabetes (t=0.627),fasting blood glucose (t=1.049),systolic pressure (t=1.056), diastolic pressure (t = 0.5 1 7 ), history of hypertension (χ2 = 0.356 ), nephropathy (χ2 = 1.242 ), preoperative laser photocoagulation (χ2 = 1.225 )and All the patients underwent three port pars plana vitrectomy.The mean follow-up was 2 years ranging from 6 months to 4 years.And then the incidence and onset time of postoperative vitreous hemorrhage and postoperative BCVA of the two groups were compared. Results Postoperative vitreous hemorrhage occurred in 14 of 56 eyes (25.00%)in C3 F8 tamponade group. The average onset time of postoperative vitreous hemorrhage were (64.64 ± 59.09)days ranging from 7 -225 days and mostly were within 30-60 days (35.71%,5/14).Postoperative vitreous hemorrhage also occurred in 7 of 71 eyes (9.89%)of silicone oil tamponade group after silicone oil removal with an average onset time of (25.29±20.46)days ranging from 3-65 days and were mostly within 1 5-30 days (42.86%, 3/7).There was a significant difference in the incidence of postoperative vitreous hemorrhage between the two groups (χ2 = 5.200,P <0.05 ).BCVA of the two groups was improved significantly after operation (Z =2.472,3.1 14;P <0.05).Postoperative BCVA of silicone oil tamponade group was poorer than C3 F8 tamponade group (Z =1.968,P <0.05).Conclusion Both C3 F8 and silicone oil tamponade can improve the visual acuity after vitrectomy for PDR.Compared with C3 F8 ,silicone oil tamponade had lower incidence and late onset of postoperative vitreous hemorrhage after vitrectomy for PDR.
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Objective To investigate the clinical efficacy and surgical timing of vitrectomy combined with silicone oil tamponade for severe infectious endophthalmitis. Methods Sixty-two patients (62 eyes)with endophthalmitis, diagnosed by the examinations of the best corrected visual acuity (BCVA),intraocular pressure, slit-lamp microscopy, direct and (or) indirect ophthalmoscopy and ocular B-ultrasound. There are 44, 17 and 1 eyes with posttraumatic, postoperative and endogenous infectious endophthalmitis, respectively. The patients were randomly divided into the group A (32 eyes) and B (30eyes). The former was treated immediately by vitrectomy combined with silicone oil tamponade after diagnosis, while the latter was treated by the same surgery after drug treatment depended on patients'choice. Vitreous purulence was taken in all patients before vitrectomy for bacterial, fungal culture and drug sensitivity test. 19/62 (30.65%) vitreous samples were positive for culture. The follow-up was ranged from 6 to 26 months. The visual acuity, intraocular pressure and eye retention situation before and after surgery were comparatively analyzed. Results In group A, endophthalmitis was controlled in all eyes after surgery;the visual acuity and intraocular pressure improved significantly after surgery (χ2=43.72, 6.83; P＜0.05). In group B, endophthalmitis was controlled in 19/30 eyes (63.33%) after surgery; evisceration was performed on 11 eyes (36.67%) because of the atrophy of the eyeball. There was no significant difference of visual acuity before and after surgery. Conclusions Vitrectomy combined with silicone oil tamponade is an effective way to cure severe infected endophthalmitis. Performing the surgery immediately after the diagnosis is the key to achieve good effect.
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Objective To evaluate the long-term results of vitreoretinal surgery without use of intraocular silicone oil or gas in patients with diabetic tractional retinal detachment (DTRD).Methods The clinical interventional case series study included 104 patients (112 eyes) with DTRD,who were consecutively treated by pars plana vitrectomy without use of intraocular silicone oil or gas.Among the eyes,there were 6 eyes with iris neovascularization (INV),1 eye with neovascular glaucoma (NVG) and 50 eyes with macular retinal detachment.There were no pre-existing retinal holes or breaks prior to surgery nor any iatrogenie retinal breaks developed during vitrectomy.Cataract removal combined with intraoeular lens implant surgeries were performed on 15 eyes.Follow-up duration varied from 12 to 65 months (mean: 29 months).Results Subretinal fluid was completely absorbed within 2 months after surgery.In 107 eyes (95.54%),the retina reattached after surgery and remained attached till the end of follow-up period.Best corrected visual acuity (BCVA) improved in 79 eyes (70.53%),remained unchanged in 14 eyes (12.500%) and got worse in 19 eyes (16.79%).The BCVA improving rate was lower in the macular detached group (33 eyes/50 eyes,66.00% Vs 46 eyes/62 eyes,74.19%,χ2=0.89,P=0.344).No obviously aggravated opacity of lens was observed after vitreoretinal surgeries in the eyes without cataract surgeries.Seven (6.25%) eyes showed INV (5 new onset eyes),and none of them developed into NVG.In multivariate logistic regression,factors associated with postoperative rubeosis iridis were pre-existing rubeosis iridis I-adjusted odds ratio (OR)= 10.2],low preoperative BCVA (OR= 11.1) and low postoperative BCVA (OR = 16.7).Conclusions Vitreoretinal surgery for DTRD may not necessarily be combined with silicone oil or gas tamponade if there are no preoperative or intraoperative retinal breaks,and only using irrigation fluid could access a good long-term prognosis result.
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Objective To invesligate the treatment of retinal detachment(RD) after silicone oil tamponades(SOT). Methods The records of a consecutive series of 32 eyes with redetachment of retina after SOT surgery between 1998 to 2000 were reviewed retrospectively. The surgical techniques used for these cases included remove of silicon oil,peeling of preretinal membrane, retinotomy, endolaser photocoagutation, secondary vitrectomy and C 3F 8 tamponades. Results In 28 of 32 eyes the retina was reattached (87.6%). The postoperative visual acuity was improved in 12 eyes, redused in 4 eyes and remained no change in 16 eyes. The postoperative complications in 6 eyes included secondary glaucoma(3 eyes), hypotony (1 eye) and hyphema (2 eyes). Conclusion The techniques of preretinal membrane peeling, retinotomy, endophotocoagulation and C 3F 8 tamponades can be effectively used in combination to treat the redetachment of retina after the silicone oil tamponades surgery.
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Objective To evaluate glaucoma and anterior chamber angle changes after intravitreal silicone oil injection(SOI). Methods The intraocular pressure(IOP) and anterior chamber angles of 34 eyes(33 patients)undergone pars plana vitrectomy and SOI were observed. Results Glaucoma occurred in 9 eyes(26%),in which silicone oil glaucoma(SOG)accounted for 77%(7/9).The changes of the superior part of anterior chamber angle were peripheral anterior synechiae in 11 eye(32%) and SO emulsification droplets in 22 eyes(64%) in 1～4.5 months after surgeries.Glaucoma occurred in 6 eyes of 7 eyes undergone peripheral iridectomy at the inferior part of the iris after the closure of iridectomy holes(P