Silicone oil-filled foldable capsular vitreous body versus silicone oil endotamponade for treatment of no light perception following severe ocular trauma

Abstract Background: Recently, a new type of foldable capsular vitreous body (FCVB) has been developed for clinical application to fill the vitreous cavity with vitreous substitutes. It may be an ideal substitute for the vitreous body in eyes with severe retinal detachment. The aim of this study was to assess the application of a foldable capsular vitreous body (FCVB) in the treatment of severe ocular trauma and silicone oil (SO) dependent eyes.Methods: A retrospective analysis was performed on the clinical application of FCVB in the treatment of severe ocular trauma and SO dependent eyes. The results of best-corrected visual acuity and intraocular pressure (IOP) evaluation, B-scan ultrasonography or color Doppler ultrasonography, ultrasound biomicroscopy, and anterior segment photography were recorded during follow-up. A paired t-test was used to compare the difference in IOP before and after FCVB implantation. Results: Seven eyes of seven patients were included in the 6 months follow-up. In all cases, B-scan ultrasonography and ultrasound biomicroscopy showed that FCVB adapted closely to the globe wall and ciliary body, thus supporting the retina. Visual acuity did not improve, except in one case from LP to HM. The mean±SD IOP was 9.29±1.60mmHg prior to FCVB implantation and 10.43±0.98mmHg after implantation, with no significant difference between these measurements (P=0.066). Five of the seven patients developed differing degrees of corneal opacity and keratopathy. Conclusions: FCVB implantation may be a safe and effective method for the treatment of severe ocular trauma and SO dependent eyes. However, corneal opacity and keratopathy are potential serious complications after surgery. Appropriate case selection and proper surgical time require further investigation.

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Outcomes of a Foldable Capsular Vitreous Body Implantation: A Retrospective Study

Disease Markers ◽

10.1155/2021/6575195 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Xiangzhong Xu ◽

Huimin Ge ◽

Jiajun Li ◽

Weihong Shang ◽

Yuke Ji ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Anterior Chamber ◽

Ocular Trauma ◽

Silicone Oil ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Vitreous Body ◽

Fundus Photography ◽

Clinical Value

Background. The vitreous body is an important part of the ocular body fluid. A foldable capsular vitreous body (FCVB) is designed to treat chronic adverse complications in severe ocular trauma and silicone oil-dependent eyes. This study is aimed at investigating a method for implanting an FCVB, its postoperative efficacy, and clinical value. Methods. A retrospective analysis was performed on data from 18 patients who underwent vitrectomy and FCVB implantation for severe ocular trauma and silicone oil-dependent eyes between March 2019 and May 2020. All treated eyes underwent clinical examinations involving the best-corrected visual acuity, intraocular pressure, FCVB position, anterior segment photography, and wide-angle fundus photography regularly after surgery. Results. Eighteen eyes from 18 patients were enrolled in this study. A total of 2.00–4.20 ( 3.46 ± 0.78 ) ml of silicone oil were injected into the FCVB during surgery. The patients were followed up at 1, 2, and 4 weeks and 3, 6, and 12 months after surgery. Twelve months after surgery, visual acuity improved in 7 (38.89%) eyes. In contrast, 10 (55.56%) eyes showed no obvious improvement, and 1 (5.56%) eye had decreased vision. Intraocular pressure at 12 months was 10.13 ± 3.52 mmHg, which was comparable to that before the surgery ( t = 0.38 , P = 0.71 ). The anterior chamber depth examined by slit lamp was 2.00–3.00 cornea thickness (CT) in 7 eyes, 1.00–2.00 CT in 2 eyes, and <1.00 CT in one eye. The anterior chamber disappeared in eight eyes. There were eight eyes with clear cornea, four eyes with localized opacity, and two eyes with obvious gray-white opacity. There was no case of severe FCVB deflection, rupture, or exposure during the observation period. Conclusion. FCVB implantation is an effective and safe treatment for eyes with severe ocular trauma and silicone oil-dependent eyes. It may support retinal reattachment, slow down eyeball atrophy, reduce the risk of chronic adverse complications such as corneal endothelial decompensation, and maintain intraocular pressure and preoperative visual function.

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Study on the effectiveness and safety of Foldable Capsular Vitreous Body implantation

BMC Ophthalmology ◽

10.1186/s12886-019-1268-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Xiangyang Zhang ◽

Xuemin Tian ◽

Baike Zhang ◽

Lisa Guo ◽

Xiaodan Li ◽

...

Keyword(s):

Retinal Detachment ◽

Ocular Trauma ◽

Silicone Oil ◽

Vitreous Body ◽

Fundus Photography ◽

Specular Microscopy ◽

Applanation Tonometer ◽

Before And After ◽

Fellow Eyes

Abstract Background Foldable capsular vitreous body (FCVB) was designed to treat severe retinal detachment. The aim of this study was to evaluate the efficacy and safety of the implantation of foldable capsular vitreous body in 1-year follow-up. Methods A retrospective analysis was conducted for 20 patients with severe ocular trauma or silicone oil (SO) dependent eyes underwent vitrectomy and FCVB implantation in a 1-year follow-up. All treated eyes were peformed clinical examinations involved the visual acuity (VA) examination, Goldmann applanation tonometer, noncontact specular microscopy, fundus photography, B-Scan examination and optical coherence tomography (OCT). The groups were compared with t-test and the McNemar - Bowker test. Results In 1-year follow-up, 20 eyes were evaluated in the study. FCVB well supported the vitreous retina in all treated eyes, and 6 treated eyes achieved retinal reattachment 12 months after FCVB implantation. There were no significant differences in VA before and after FCVB implantation (P = 1.000). In addition, the postoperative IOP markedly elevated from the preoperative IOP of 12.90 ± 7.06 mmHg to 15.15 ± 3.36 mmHg (P = 0.000017). The intraocular pressure (IOP) of 10 eyes maintained at a normal level after surgeries. The other 10 eyes showed slightly lower IOP within the acceptable level. Though two patients developed keratopathy and ocular inflammation respectively, other treated eyes were symmetric with fellow eyes showing satisfactory appearance. Moreover, there was no SO emulsification or leakage happened in the observation. Conclusions FCVB implantation was an effective and safe treatment in the eyes with severe retinal detachment.

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Biomedical Materials to Repair Retinal Detachments

MRS Proceedings ◽

10.1557/proc-55-55 ◽

1985 ◽

Vol 55 ◽

Author(s):

Miguel F. Refojo

Keyword(s):

Retinal Detachment ◽

Silicone Rubber ◽

Methyl Acrylate ◽

Silicone Oil ◽

Vitreous Body ◽

Light Sensitivity ◽

Scleral Buckling ◽

Intraocular Injection ◽

Other Substances

ABSTRACTImplants are essential for the repair of retinal detachments. The implant buckles the wall of the eye and apposes the detached retina with the choroid, thus restoring light sensitivity to the retina. The scleral buckling also relieves traction on the retina from a shrinking vitreous body. The implant materials most commonly used are solid silicone rubber and silicone sponges, but both types have some disadvantages. A poly(hydroxyethyl acrylate-co-methyl acrylate) hydrogel implant with improved properties of softness and antibiotic absorption is also available for retinal detachment surgery. Proliferative vitreoretinopathy involves various conditions of retinal detachment complicated by vitreous fibrosis, which, after vitrectomy, may be treated with intraocular injection of fluids that support the retina against the choroid. For conditions requiring a long-term implant, silicone oil although controversial is the material of choice. Many other substances have been investigated but none better has yet been found.

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Risk factors and prognosis of pediatric open globe injuries without initial light perception

Ophthalmologica ◽

10.1159/000513337 ◽

2020 ◽

Author(s):

Xin Wen ◽

Miner Yuan ◽

Cheng Li ◽

Chongde Long ◽

Zhaohui Yuan ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Silicone Oil ◽

Vitreoretinal Surgery ◽

Light Perception ◽

Open Globe ◽

Intraocular Hemorrhage ◽

Control Study ◽

Better Than ◽

Open Globe Injuries

Purpose: To investigate the possible risk factors and prognosis of initial no light perception (NLP) in pediatric open globe injuries (POGI). Procedures: This retrospective, comparative, interventional case-control study included 865 eyes of POGI patients presenting to a tertiary referral ophthalmic center from 1 January 2011 to 31 December 2015. Eyes were divided into two groups: NLP group included eyes with initial NLP, and light perception(LP) group included eyes with initial LP or vision better than LP. Results: The following risk factors were significantly related to initial NLP: severe intraocular hemorrhage (OR=3.287, p=0.015), retinal detachment (RD) (OR=2.527, p=0.007), choroidal damage (OR=2.680, p=0.016) and endophthalmitis (OR=4.221, p＜0.001). Choroidal damage is related to remaining NLP after vitreoretinal surgery (OR=12.384, p=0.003). At the last visit, more eyes in the NLP group suffered from silicone oil–sustained status (OR=0.266, p=0.020) or ocular atrophy (OR=0.640, p=0.004), and less eyes benefitted from final LP (OR=41.061, p＜0.001) and anatomic success (OR=4.515, p＜0.001). Conclusion: Severe intraocular hemorrhage, RD, choroidal damage and endophthalmitis occurred more often in POGI with initial NLP. Choroidal damage was the major factor related to an NLP prognosis. Traumatized eyes with initial NLP could be anatomically and functionally preserved by vitreoretinal surgery.

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Silicone Oil Injection After Failed Primary Vitreous Surgery in Severe Ocular Trauma

American Journal of Ophthalmology ◽

10.1016/0002-9394(89)90501-1 ◽

1989 ◽

Vol 107 (5) ◽

pp. 537-543 ◽

Cited By ~ 12

Author(s):

Andrew N. Antoszyk ◽

Brooks W. McCuen Ii ◽

Eugene de Juan ◽

Robert Machemer

Keyword(s):

Ocular Trauma ◽

Silicone Oil ◽

Vitreous Surgery ◽

Oil Injection

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Limitation of computed tomography scan in ocular trauma in diagnosing posterior globe rupture and retinal detachment

Trauma ◽

10.1177/1460408616677563 ◽

2016 ◽

Vol 20 (1) ◽

pp. 72-76

Author(s):

AR Munirah ◽

MK Safinaz ◽

ZMZ Aida ◽

A Malisa ◽

MI Hazlita

Keyword(s):

Computed Tomography ◽

Retinal Detachment ◽

Ocular Trauma ◽

Silicone Oil ◽

Primary Repair ◽

Computed Tomography Scan ◽

Penetrating Eye Injury ◽

Globe Rupture ◽

Open Globe ◽

Tomography Scan

Ocular trauma with penetrating eye injury or globe rupture is an ophthalmic emergency. Immediate but gentle ocular assessment is mandatory to diagnose the extent of the injury. Imaging modalities are valuable in aiding diagnosis and management in open globe injury due to the difficulty of full eye assessment in the presence of multiple head and facial injuries. This report presents a case of an elderly man with ocular trauma of the left only seeing eye where computed tomography scan showed anterior globe rupture and the possibility of posterior globe rupture due to discontinuity of the posterior sclera. Primary repair and exploration of the left eye revealed no posterior globe rupture. Post-operative B-scan revealed a total retinal detachment with intact posterior globe. Vision of the left eye after pars planar vitrectomy and tamponade of the retina detachment with heavy silicone oil improved to 1/60. Computed tomography scan in ocular trauma has limitations especially in diagnosing retinal detachment and posterior globe rupture.

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Ultrasound findings in a case of Eales’ disease and ocular trauma with anterior chamber cholesterolosis

BMC Ophthalmology ◽

10.1186/s12886-020-01660-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Peng Lu ◽

Jingjing Huang

Keyword(s):

Anterior Chamber ◽

Ocular Trauma ◽

Vitreous Body ◽

Ultrasound Biomicroscopy ◽

Applanation Tonometry ◽

Potential Mechanism ◽

Rare Phenomenon ◽

Ultrasound Findings ◽

Eales Disease ◽

The Right

Abstract Background Anterior chamber cholesterolosis is a rare phenomenon which occurs mostly in chronically blind eyes. We present the anterior and posterior ultrasound findings in a case of anterior chamber cholesterolosis secondary to Eales’ disease and ocular trauma, which may contribute to the understanding of the potential mechanism of this phenomenon. Case presentation A 48-year-old man presented with “sparking” right eye, which appeared soon after the ocular trauma. Both eyes were confirmed Eales’ disease in our center 8 years ago, and right eye remained no light perception since then. Intraocular pressure of right eye measured by Goldmann applanation tonometry was 1 mmHg. Slitlamp photograph revealed multiple polychromatic large crystals in anterior chamber. Ultrasound biomicroscopy showed that anterior chamber was filled with extensive large granular substances. Dense dotted hyperechoic foci and retinal detachment was found in B-scan ultrasound examination. The right eye was diagnosed as anterior chamber cholesterolosis secondary to Eales’ disease and ocular trauma. The patient was asymptomatic, and therefore was advised to have regular follow-up. Conclusion The findings of above imaging examinations, as well as complaint of “sparkling” eye appeared soon after ocular trauma elucidate that anterior chamber cholesterol crystals were from vitreous cavity. Any factors facilitating the communication of anterior chamber and vitreous body may lead to the occurrence of this rare phenomenon in predisposing eyes. The anterior and posterior ultrasound findings may give a clue on the potential mechanism.

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