SILICONE OIL TAMPONADE EFFECT ON MACULAR LAYER THICKNESS AND VISUAL ACUITY

Purpose: To assess the safety and efficacy of hybrid vitreous surgery combining active 23-G ports with a sutured 20-G 6-mm infusion cannula for performing vitrectomy in endophthalmitis and trauma. Methods: This is a retrospective analysis of 10 eyes with endophthalmitis and 10 eyes with trauma requiring vitreous surgery, having corneal clarity suitable for vitrectomy and best-corrected visual acuity (BCVA) greater than or equal to light perception. All patients underwent hybrid 20/23-G vitrectomy. Intraoperative notes were analyzed for peroperative complications. The BCVA and retinal status at 3 months were analyzed. Results: In the endophthalmitis group, patients ranged from 5 to 85 years of age and showed varied etiologies. Retinal detachment was present in 5 eyes, which received silicone oil tamponade. Mean preoperative logMAR visual acuity (VA) was 2.29 ± 0.45, which improved to 1.10 ± 0.72 at 3 months postoperatively (p<0.001). Trauma cases ranged from 21 to 75 years of age. Retinal detachment was present in 9 out of 10 eyes, all of which received silicone oil tamponade. Preoperative logMAR VA was 2.26 ± 0.71, which improved to 1.33 ± 0.50 postoperatively (p<0.001). At 3 months postsurgery, the retina was attached in all eyes in both groups. Conclusions: The longer sutured 20-G cannula was easier to visualize through fibrin, exudates, and hemorrhage and did not slip out or enter the suprachoroidal space in any of our cases. The 23-G active ports and vitrectomy cutter enhanced safety and efficacy. Hybrid vitrectomy enabled safe surgery in these difficult cases.

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Visual loss may be due to silicone oil tamponade effect rather than silicone oil removal

British Journal of Ophthalmology ◽

10.1136/bjo.2005.082602 ◽

2005 ◽

Vol 89 (12) ◽

pp. 1667-1667 ◽

Cited By ~ 6

Author(s):

P K Rani

Keyword(s):

Visual Loss ◽

Silicone Oil ◽

Oil Removal ◽

Silicone Oil Removal ◽

Silicone Oil Tamponade ◽

Tamponade Effect

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Surgery for Combined Hamartoma of the Retina and Retinal Pigment Epithelium

Case Reports in Ophthalmology ◽

10.1159/000518013 ◽

2021 ◽

pp. 778-783

Author(s):

Charlotte Maria van der Sommen ◽

Saskia Helena Margaretha van Romunde ◽

Koen-Willem Adriaan van Overdam

Keyword(s):

Visual Acuity ◽

Retinal Pigment Epithelium ◽

Silicone Oil ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Vitreoretinal Surgery ◽

Internal Limiting Membrane ◽

Epiretinal Membranes ◽

Vitreous Cortex ◽

Silicone Oil Tamponade

There is no consensus on whether and when surgical treatment is indicated for combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). We aim to discuss the benefits of surgical intervention and techniques that may improve the outcome. A 24-year-old man experienced progressive visual loss for 6 months in his left eye due to CHRRPE. At presentation, visual acuity was 1.3 LogMAR and fundoscopy revealed extensive tractional pre- and epiretinal membranes, subretinal exudation, and a vasoproliferative tumor in the inferior periphery. A complete vitrectomy was performed, while paying special attention to vitreous shaving at the vitreous base and removal of vitreoschisis-induced vitreous cortex remnants (VCR) from the retinal surface posterior to the vitreous base. Tractional membranes and internal limiting membrane were peeled, and the vasoproliferative tumor was excised. Silicone oil tamponade was removed 11 weeks after surgery. No intra- or postoperative complications occurred. Visual acuity improved to 0.8 LogMAR and remained stable for 48-month follow-up. Vitreoretinal surgery can prevent complications that occur with CHRRPE. In addition, visual function may improve even if the initial visual acuity is low. Timely and complete vitrectomy with extensive membranectomy and detection and removal of VCR is recommended to avoid complications in challenging CHRRPE.

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Prognostic Factors Associated with Outcomes after Giant Retinal Tear Management Using Perfluorocarbon Liquids

European Journal of Ophthalmology ◽

10.1177/112067210801800216 ◽

2008 ◽

Vol 18 (2) ◽

pp. 270-277 ◽

Cited By ~ 25

Author(s):

A.M. Al-Khairi ◽

E. Al-Kahtani ◽

D. Kangave ◽

A.M. Abu El-Asrar

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Silicone Oil ◽

Univariate Analysis ◽

Retinal Tear ◽

Giant Retinal Tear ◽

Perfluorocarbon Liquids ◽

Primary Procedure ◽

Silicone Oil Tamponade ◽

Better Than

Purpose To identify prognostic factors for visual acuity and anatomic outcomes associated with giant retinal tear management using intraoperative perfluorocarbon liquids. Methods All patients with giant retinal tears without proliferative vitreoretinopathy (PVR) who underwent management with intraoperative perfluorocarbon liquids between 1994 and 2005 were re-viewed. Results The study included 115 patients (117 eyes), 93 (80.9%) males and 22 (19.1%) females, with a mean age of 30.3±15.2 years. Mean follow-up period was 29.7±26.7 months. Success rate with primary procedure was 78.6%, which increased to 94% with multiple surgeries. On univariate analysis, factors significantly associated with final visual acuity better than 20/200 included phakic/clear lens at presentation (p=0.0113), partial retinal detachment (p=0.0233), absence of all postoperative complications (p=0.0122), absence of recurrent retinal detachment (p=0.0406), and absence of postoperative PVR (p=0.0062). Logistic regression analysis highlighted that phakic/clear lens at presentation, unfolded flap of the giant tear, absence of postoperative cataract, and absence of post-operative PVR were associated with final visual acuity better than 20/200. On univariate analysis, use of gas tamponade was significantly associated with recurrent retinal detachment (p=0.0190). Logistic regression analysis highlighted that placement of an encircling scleral buckle and use of silicone oil tamponade were associated with anatomic reattachment with primary procedure. Conclusions Encircling scleral buckling and silicone oil tamponade decrease the risk of recurrent retinal detachment.

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Long-term silicone oil tamponade in eyes with complicated retinal detachment

European Journal of Ophthalmology ◽

10.1177/11206721211019551 ◽

2021 ◽

pp. 112067212110195

Author(s):

Orit Vidne-Hay ◽

Eva Platner ◽

Amir Alhalel ◽

Joseph Moisseiev

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Silicone Oil ◽

Final Visual Acuity ◽

Complication Rates ◽

Ocular Surgery ◽

Group A ◽

Silicone Oil Tamponade ◽

Group B

Purpose: To report the visual and anatomic outcomes of eyes with exceedingly long-term silicone oil tamponade. Methods: A retrospective chart review of 43 eyes of 41 patients with silicone oil tamponade for 5 years or more. Rates of retinal reattachment, visual acuity, and complications are presented. Further analysis was performed to identify if silicone oil complications are more common in eyes with lower vision. For this, cases were divided into group A-visual acuity of 20/400 or better and group B-visual acuity of less than 20/400. Results: Mean silicone oil duration was 12.6 ± 6.3 years. The etiology at presentation included: recurrent RRD (60.46%), RRD secondary to trauma (25.58%), and TRD (13.95%). Ninety-three percent of eyes underwent at least one ocular surgery before the vitrectomy with silicone oil tamponade. The retinal attachment rate was 55.8%. Mean visual acuity at presentation was 2.03 ± 0.6 logMAR, and at the final follow-up, 1.85 ± 0.78 logMAR ( p = 0.166). Emulsification developed in 33.3% of cases, glaucoma in 28.6%, band keratopathy in 21.4%, and corneal decompensation in 16.7%. In 26.2% of eyes, the final visual acuity was 20/400 or better (group A). In 73.8% of eyes, final visual acuity was worse than 20/400 (group B). The rates of silicone oil emulsification and glaucoma were not statistically significant between groups. Conclusions: Long-term silicone oil tamponade is a possible option in eyes with complicated retinal detachment following multiple intravitreal procedures, although the complication rates are relatively high. In 26.2% of eyes, visual acuity of 20/400 or better can be preserved for many years.

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Pars plana vitrectomy with silicone oil tamponade for primary and secondary macular hole closure: Is it still a useful procedure?

European Journal of Ophthalmology ◽

10.1177/1120672117752423 ◽

2018 ◽

Vol 28 (5) ◽

pp. 503-514 ◽

Cited By ~ 2

Author(s):

Janusz Pieczynski ◽

Patrycja Kuklo ◽

Andrzej Grzybowski

Keyword(s):

Visual Acuity ◽

Macular Hole ◽

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Surgical Techniques ◽

Successful Outcome ◽

Gas Tamponade ◽

Pars Plana ◽

Silicone Oil Tamponade ◽

Hole Closure

Purpose: To evaluate usefulness of posterior vitrectomy with silicone oil tamponade for primary and secondary macular hole closure. Methods: We searched for publications on the surgical treatment of full-thickness idiopathic and recurrent macular hole. We divided reports into two groups: primary macular hole repair and recurrent macular hole repair with silicone oil tamponade. Results: In primary macular hole treatment, different authors confirmed effectiveness of silicone oil tamponade. They suggest that the most important factor for successful outcome was completeness of vitreous cavity filling with oil. Complications after this method were comparable to those after gas tamponade. However, even if good anatomical results are achieved in secondary macular hole closure, visual acuity is sometimes less rewarding. Conclusion: There are reports on good efficacy of silicone oil tamponade for primary and recurrent macular hole closure. Anatomical closure and visual acuity rates in pars plana vitrectomy with silicone oil and with gas filling are comparable. Gas tamponade seems to be safer and needs no more surgery. Postoperative complications in both methods are similar, but all patients with silicone oil filling need to undergo a reoperation to have the silicone removed. There are also other surgical techniques for primary macular hole closure as well as for unsuccessful primary macular hole procedures. We think that primary macular hole closure should be performed with gas tamponade, supported with different adjuvants, as a method of choice. Silicone oil tamponade could be still an alternative in cases, when there are no more efficient techniques or possibilities to treat with success recurrent macular hole.

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Surgery of cicatricial stage of choroidal neovascular membrane with autologous conditioned plasma

Russian Ophthalmological Journal ◽

10.21516/2072-0076-2021-14-4-18-21 ◽

2021 ◽

Vol 14 (4) ◽

pp. 18-21

Author(s):

D. G. Arsyutov

Keyword(s):

Visual Acuity ◽

Silicone Oil ◽

Platelet Rich Plasma ◽

Functional Results ◽

Suture Fixation ◽

Choroidal Neovascular Membrane ◽

Inner Limiting Membrane ◽

Silicone Oil Tamponade ◽

Late Postoperative Period

Purpose. To estimate the effectiveness of the cicatricial stage of choroidal neovascular membrane (CNM) surgery with retina fixation after retinotomy of paracentral areas with autologous conditioned platelet rich plasma (ACP) and without endolaser photocoagulation and silicone oil tamponade. Material and methods. 17 CNM patients aged 49 to 82 with visual acuity from 0.02 eccentric to 0.08 were operated. The operation consisted in 25-, 27+-gauge vitrectomy, removal of the posterior hyaloid membrane and the inner limiting membrane (in the presence of an epiretinal membrane), paracentral retinotomy, removal of the choroidal neovascular membrane via retinotomy, pneumoretinopexy, 2–3 layer instillation of ACP in the retinotomy area without endolaser photocoagulation and silicone oil tamponade, seamless closure of sclera- and conjunctivotomy with a layer of autologous conditioned plasma. Results. Full retinal reattachment and closure of the retinotomy opening in the late postoperative period was noted in all patients. No case of recurrent retinal detachment was recorded. Complete closure of sclera- and conjunctivotomy with no additional suture fixation was achieved in all cases. In the long-term period after the removal of the cicatricial choroidal membrane, visual acuity was 0.03–0.2. Conclusion. The modern surgery of the cicatricial stage of CNM using ACP to close the retinotomy defect after removal of cicatricial CNV without endolaser coagulation of the retina and silicone tamponade, followed by seamless blocking of the sclero- and conjunctivotomy with ACP produces excellent anatomical and functional results, minimizing the risk of postoperative complications.

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Rationale for Clinical Approaches to the Use of Modern Pharmacological Neuroprotection in Patients after Endovitreal Surgery of Rheumatogenic Retinal Detachment

Acta biomedica scientifica ◽

10.29413/abs.2019-4.4.14 ◽

2019 ◽

Vol 4 (4) ◽

pp. 96-101

Author(s):

A. V. Egorov ◽

V. V. Egorov ◽

G. P. Smoliakova

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Silicone Oil ◽

Efficiency Index ◽

Doppler Flowmetry ◽

Visual Prognosis ◽

Visual Functions ◽

Low Level ◽

Silicone Oil Tamponade ◽

Tolerable Level

Background. Annual disability index among patients with rheumatogenic retinal detachment (RRD) is 2–9 %. One of the factors, causing the development of morphofunctional disorders of macula, is the change in intraocular hemodynamics. Aim: substantiation of rational timing of neuroprotection with cytoflavin depending on the prediction of visual functions after endovitreal surgery of RRD.Materials and methods. There were 21 patients (21 eyes) with RRD. A three-port vitrectomy with silicone tamponade and its subsequent removal was performed. Two groups of patients: the 1st group – 10 patients with tolerable prediction of restoration of visual functions (increasing of visual acuity to 0.4–0.2 relative units), the 2nd group – 11 people with low level of visual prognosis (increasing of visual acuity to 0.15 and lower). All patients received cytoflavin at both stages of surgery. We used laser doppler flowmetry (microcirculation index (MI) and microcirculation efficiency index (MEI)). The criteria of “sufficiency” of cytoflavin receiving was periods of recovery of MI and MEI to indexes that were not significantly different from the norm.Results. Dynamics of response of chorioretinal microcirculation at both stages of endovitreal surgery of RRD was unidirectional. At the same time, the indexes of MI and MEI under influence of cytoflavin in patients with tolerable level of visual prognosis reached maximum index at the 15th day of observation as at the stage of silicone oil tamponade and after its removal; and in patients with low level of visual prognosis only at the 25th day of observation.Conclusions. Therapy with cytoflavin neuroprotection in patients after endovitreal surgery of RRD leads to significant increase of indexes of chorioretinal blood flow. The period of cytoflavin treatment justified until achievement of the required positive dynamics of chorioretinal microcirculation depending on the level of visual prognosis: tolerable – 15 days, low – 25 days.

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Transscleral Removal of Subretinal Strand without Vitrectomy: A Case Report

Case Reports in Ophthalmology ◽

10.1159/000516850 ◽

2021 ◽

pp. 766-772

Author(s):

Yongping Tang ◽

Ronghan Wu

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Silicone Oil ◽

Vitreoretinal Surgery ◽

Scleral Buckling ◽

Oil Removal ◽

Corrected Visual Acuity ◽

Silicone Oil Tamponade ◽

Best Corrected Visual Acuity ◽

Subretinal Strand

Recurrence of inferior retinal detachment, after vitreoretinal surgery and silicone oil tamponade, along with a subretinal strand, presents a challenge for surgeons. Vitrectomy and retinotomy are the usual treatment in such cases. Here, we present a new transscleral method for addressing this problem. A 13-year-old boy with recurrent retinal detachment after silicone oil tamponade underwent scleral buckling surgery and had a transscleral subretinal strand removed without retinotomy. The retina reattached, and silicone oil was removed 3 months later. The best-corrected visual acuity was 0.4 in decimal vision at 1 year after silicone oil removal. Scleral buckling surgery combined with subretinal strand removal may be used as an alternative to retinotomy, especially for patients with an inferior retinal detachment and local subretinal strand formation.

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