Surgical Management of Intraocular Silicone Oil Microdroplet

2019 ◽  
Vol 236 (04) ◽  
pp. 568-570
Author(s):  
Antoine Safi ◽  
Thomas Wolfensberger
Keyword(s):  
Visual Field ◽  
Surgical Technique ◽  
Physical Properties ◽  
Silicone Oil ◽  
Visual Disturbance ◽  
Clinical Recovery ◽  
Deep Indentation ◽  
Vitreous Opacities ◽  
Pars Plana ◽  
Disposable Instruments

Abstract Purpose Intraocular silicone oil microdroplets have been described after intravitreal injection of anti-VEGF agents packaged at a compound pharmacy. We present a case with the presence of an intraocular silicone oil microdroplet after a vitreoretinal operation using disposable instruments, and the surgical technique for its removal. Methods A 59-year-old patient who had been operated on for vitreous opacities using a disposable 27-g vitrectomy kit complained of a small round structure floating in the eye. It appeared a few days after surgery. The bubble was not present at all times and it disappeared for days on end. Clinical examination of the vitreous and retina during these uneventful periods was normal. The bubble reappeared intermittently without a link to any specific movement for some time but was again absent once the patient was examined. The physical properties of the mobile round lesion could be identified as lighter than aqueous humor, as it was described as being in the center of the visual field if the head was tilted forward. Results As the patient was very bothered by this bubble, a 23-g vitrectomy was performed. During deep indentation of the pars plana over 360 degrees, a tiny bubble of silicone oil could be found buried in the peripheral vitreous base, and controlled aspiration under deep indentation was performed. The patient has been without symptoms since the removal of the droplet and made an uneventful clinical recovery. Conclusion Microdroplets of silicone oil may be present in disposable vitreoretinal instruments and stay in the eye after surgery, causing a visual disturbance. The origin of these droplets may be linked to the plastic tubing of the instruments.

scholarly journals Apolipoprotein AI-Derived Vitreous Amyloidosis: An Elusive Diagnosis

2020 ◽  
Vol 11 (2) ◽  
pp. 287-292
Author(s):  
Juan B. Yepez ◽  
Felipe A. Murati ◽  
Michele  Petitto ◽  
Jazmin De Yepez ◽  
Jose M. Galue ◽  
...  
Keyword(s):  
Posterior Vitreous Detachment ◽  
Anterior Segment ◽  
Visual Disturbance ◽  
Apolipoprotein Ai ◽  
Polarized Microscopy ◽  
Vitreous Opacity ◽  
Vitreous Opacities ◽  
Pars Plana ◽  
Fundoscopic Examination ◽  
Vitreous Biopsy

A 56-year-old female presented with vitreous opacity with gradual visual disturbance in her right eye of 1-year duration. A Non-Hodgkin’s lymphoma had been treated 15 years before. Presenting best-corrected visual acuity (BCVA) was 20/200 in her right eye and 20/25 in her left eye. Intraocular pressure was 18 mm Hg bilaterally. Slit-lamp examination revealed no abnormal findings in the anterior segment of both eyes, including the absence of cells and flare. Fundoscopic examination indicated hazy media with the typical glass-wool-like appearance in her right eye. B-scan ultrasound demonstrated that the vitreous was full of middle-echo spots, vitreous opacities, and posterior vitreous detachment occurred. The patient underwent vitreous biopsy and a standard 25-gauge pars plana vitrectomy (diagnostic and therapeutic). Intraoperatively, the eye was noted to have severe diffuse debris and very strong vitreoretinal adhesions. Cytospin smears prepared from the vitreous aspirate indicated amorphous acellular material that stained positively with Congo Red and showed apple green birefringence on polarized microscopy, consistent with the diagnosis of amyloidosis. A genetic evaluation of tongue tissue demonstrated apolipoprotein AI-derived amyloidosis. The BCVA was 20/25 OU at 3 months postoperatively.

scholarly journals Hemorrhagic Retinal Macrocyst with Retinal Detachment

2021 ◽  
Vol 62 (9) ◽  
pp. 1300-1304
Author(s):  
Ye Eun Han ◽  
Hyun-Ah Kim ◽  
June-Gone Kim
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Visual Disturbance ◽  
The Face ◽  
History Of ◽  
Pars Plana ◽  
23 Gauge ◽  
One Year ◽  
Oil Injection

Purpose: To report a satisfactory clinical outcome of hemorrhagic retinal macrocyst with retinal detachment after pars plana vitrectomy and silicone oil injection. Case summary: A 33-year-old man visited our clinic with a 1-week history of visual disturbance in his left eye. His ocular and medical history were unremarkable, and best-corrected visual acuity (BCVA) in the left eye was 20/40. Fundoscopic examination of the left eye showed a hemorrhagic retinal macrocyst that was well-demarcated, semi-transparent, dome-shaped, and larger than 8 disc diameters at the superonasal location, with macular-off retinal detachment. B-scan ultrasonography also confirmed the presence of an intra-retinal cystic lesion with internal mobile echogenic signals representing blood. The patient underwent 23-gauge pars plana vitrectomy, barrier laser photocoagulation around the retinal tear and boundary of the cyst, and silicone oil injection, without any other additional procedures for the hemorrhagic retinal macrocyst. After the surgery, the patient stayed in the face down position for two weeks. Three months postoperatively, a completely collapsed hemorrhagic retinal macrocyst with successful retinal reattachment was observed. Six months later, the BCVA in the left eye had improved to 20/30. One year later, even after silicon oil removal, the collapsed hemorrhagic retinal macrocyst and reattached retina remained stable.Conclusions: A hemorrhagic retinal macrocyst with retinal detachment was successfully treated with pars plana vitrectomy and silicone oil tamponade.

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

Management of a case of Enhanced S-cone syndrome with massive foveoschisis treated with pars plana vitrectomy with silicone oil tamponade

2021 ◽  
pp. 1-4
Author(s):  
Lorane Bechet ◽  
Raphaël Atia ◽  
Christina Zeitz ◽  
Saddek Mohand-Saïd ◽  
José-Alain Sahel ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
Enhanced S Cone Syndrome

scholarly journals TREATING UVEITIS-ASSOCIATED HYPOTONY WITH PARS PLANA VITRECTOMY AND SILICONE OIL INJECTION

Retina ◽  
2010 ◽  
Vol 30 (1) ◽  
pp. 140-145 ◽  
Author(s):  
RASHMI KAPUR ◽  
ANDREA D. BIRNBAUM ◽  
DEBRA A. GOLDSTEIN ◽  
HOWARD H. TESSLER ◽  
MICHAEL J. SHAPIRO ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Pars Plana ◽  
Oil Injection

Arteriovenous malformations in the optic apparatus: systematic literature review and report of four cases

2021 ◽  
pp. 1-11
Author(s):  
Visish M. Srinivasan ◽  
Phiroz E. Tarapore ◽  
Stefan W. Koester ◽  
Joshua S. Catapano ◽  
Caleb Rutledge ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Function ◽  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Visual Fields ◽  
Optic Tract ◽  
Visual Disturbance ◽  
Visual Field Defects ◽  
Subtotal Resection

OBJECTIVE Rare arteriovenous malformations (AVMs) of the optic apparatus account for < 1% of all AVMs. The authors conducted a systematic review of the literature for cases of optic apparatus AVMs and present 4 cases from their institution. The literature is summarized to describe preoperative characteristics, surgical technique, and treatment outcomes for these lesions. METHODS A comprehensive search of the English-language literature was performed in accordance with established Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all published cases of AVM in the optic apparatus in the PubMed, Web of Science, and Cochrane databases. The authors also searched their prospective institutional database of vascular malformations for such cases. Data regarding the clinical and radiological presentation, visual acuity, visual fields, extent of resection, and postoperative outcomes were gathered. RESULTS Nine patients in the literature and 4 patients in the authors’ single-surgeon series who fit the inclusion criteria were identified. The median age at presentation was 29 years (range 8–39 years). Among these patients, 11 presented with visual disturbance, 9 with headache, and 1 with multiple prior subarachnoid hemorrhages; the AVM in 1 case was found incidentally. Four patients described prior symptoms of headache or visual disturbance consistent with sentinel events. Visual acuity was decreased from baseline in 10 patients, and 11 patients had visual field defects on formal visual field testing. The most common visual field defect was temporal hemianopia, found in one or both eyes in 7 patients. The optic chiasm was affected in 10 patients, the hypothalamus in 2 patients, the optic nerve (unilaterally) in 8 patients, and the optic tract in 2 patients. Six patients underwent gross-total resection; 6 patients underwent subtotal resection; and 1 patient underwent craniotomy, but no resection was attempted. Postoperatively, 9 of the patients had improved visual function, 1 had no change, and 3 had worse visual acuity. Eight patients demonstrated improved visual fields, 1 had no change, and 4 had narrowed fields. CONCLUSIONS AVMs of the optic apparatus are rare lesions. Although they reside in a highly eloquent region, surgical outcomes are generally good; the majority of patients will see improvement in their visual function postoperatively. Microsurgical technique is critical to the successful removal of these lesions, and preservation of function sometimes requires subtotal resection of the lesion.

scholarly journals Occupational eye hazard – a case of perforating industrial nail injury to the eye

2016 ◽  
Vol 15 (1) ◽  
pp. 43-46
Author(s):  
Elin Lee ◽  
Wagle Ajeet Madhav
Keyword(s):  
Unusual Case ◽  
Silicone Oil ◽  
Posterior Pole ◽  
Foreign Body Removal ◽  
Corrected Visual Acuity ◽  
Initial Injury ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
Chinese Male ◽  
Scleral Fixated Intraocular Lens

Purpose: To report the management and outcome of an unusual case of occupational perforating ocular industrial nail injury involving the posterior pole. Methods: Observational case report. A 48-year-old Chinese male construction worker presented with perforating industrial nail injury.Results: The patient underwent primary globe repair and foreign body removal followed by staged pars plana vitrectomy with endophotocoagulation and cyclopropane gas tamponade for repair of the vitreous incarceration at the posterior exit wound, a subsequent laser retinopexy with silicone oil tamponade for an inferior retinal detachment extending from the perforation site and finally silicone oil removal with a scleral fixated intraocular lens implant. His best-corrected visual acuity improved to 20/100 six months after the initial injury. Conclusion: Perforating ocular injuries involving the posterior pole often present with severe visual impairment and significant management challenges. We report a case of perforating ocular nail injury, which was managed successfully with staged surgical procedures.

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