scholarly journals The effect of silicone oil tamponade on retinal layers and choroidal thickness in patients with rhegmatogenous retinal detachment: a systematic review and meta-analysis

Author(s):  
Heshmatollah Ghanbari ◽  
Farzan Kianersi ◽  
Alireza Jamshidi Madad ◽  
Alireza Dehghani ◽  
Alireza Rahimi ◽  
...  

Abstract Background To evaluate the effects of intravitreal silicone oil (SO) on the retinal and choroidal thickness in eyes with rhegmatogenous retinal detachment (RRD). Methods A literature search was performed in Web of Science, Scopus, ProQuest, Embase, Clinical Key, Science Direct, Cochrane Library, and Springer, as well as Persian databases, including IranDoc, MagIran, SID, MOH thesis, and MOH articles until June 2020. Two reviewers independently searched and extracted the data. Results Sixteen studies (n = 391) met the inclusion criteria. The meta-analysis showed that the SO tamponade could significantly reduce the central macular thickness (CMT) in patients with RRD as compared to gas tamponade WMD = − 14.91; 95% CI: − 22.23, − 7.60; P < 0.001, I2 = 71%). No significant change was found in CMT between the eye with SO tamponade (after SO removal) and the fellow healthy eye in patients with RRD (WMD = − 3.52; 95% CI: − 17.63, 10.59; I2 = 68.6%). Compared to the preoperative stage, the SO tamponade could significantly reduce the subfoveal choroidal thickness in patients with RRD (WMD = − 18.67, 95% CI: − 30.07, − 1.28; I2 = 80.1%). However, there was no significant difference in the subfoveal choroidal thickness before and after SO removal (WMD = − 1.13, 95% CI: − 5.97, 3.71; I2 = 87.6%). Conclusion The SO tamponade had a significant effect on the reduction of retinal layers and the subfoveal choroidal thickness.

2021 ◽  
pp. 1-8
Author(s):  
Chloé Dubroux ◽  
Julia Salleron ◽  
Karine Angioi-Duprez ◽  
Jean-Paul Berrod ◽  
Jean-Baptiste Conart

<b><i>Purpose:</i></b> The aim of the study was to investigate the effect of tamponade duration on retinal changes induced by silicone oil (SO) in patients who underwent successful rhegmatogenous retinal detachment (RRD) surgery. <b><i>Methods:</i></b> Retrospective comparative case series of 68 patients who underwent SO tamponade for RRD. Patients were divided into 2 groups based on timing of SO removal: &#x3c;6 months (group 1, <i>n</i> = 34) versus ≥6 months (group 2, <i>n</i> = 34). The main outcome measure was the change in central macular, inner, and outer retinal layer thickness (CMT, IRLT, and ORLT) before and after SO removal (SOR). <b><i>Results:</i></b> The median tamponade duration was 4 [Clin Ophthalmol. 2016;10:471–6, Zhonghua Yan Ke Za Zhi. 1997 Jan;33(1):39–41] months in group 1 and 8 [Arch Ophthalmol. 1994 Jun;112(6):778–85, Retina. 2004 Dec;24(6):871–7] months in group 2 (<i>p</i> &#x3c; 0.001). The mean CMT significantly increased from 245.3 ± 22.2 μm and 238.8 ± 41.6 μm under SO to 281.3 ± 60.2 μm and 259.0 ± 43.5 μm after SOR in group 1 (<i>p</i> = 0.009) and in group 2 (<i>p</i> = 0.007), respectively. Automated segmentation measurement revealed a significant increase in mean IRLT (<i>p</i> = 0.014 and <i>p</i> = 0.013) but no change in mean ORLT (<i>p</i> = 0.080 and <i>p</i> = 0.257) in both groups. After adjustment, there was no difference between the 2 groups in terms of mean final CMT, IRLT, and ORLT and mean retinal thickness changes after SOR. There was also no correlation between the tamponade duration and macular microstructural changes or visual recovery. <b><i>Conclusion:</i></b> SO tamponade causes a thinning of all retinal layers, mainly affecting the inner retinal layer. However, these changes resolved following SO extraction and were not affected by longer tamponade duration.


2020 ◽  
Vol 9 (12) ◽  
pp. 4037
Author(s):  
Josef Guber ◽  
Maico Bentivoglio ◽  
Christophe Valmaggia ◽  
Corina Lang ◽  
Ivo Guber

Purpose: To investigate clinical and surgical factors influencing the outcome after primary rhegmatogenous retinal detachment surgery. Methods: A retrospective, single-centre, case-control study of 1017 eyes of 1017 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV), were included in the study. Analysed surgical factors were: combined procedure with phacoemulsification, type of retinopexy (cryocoagulation, endolaser, combined), type of tamponade (gas, silicone oil), and anatomical factors: primary proliferative vitreoretinopathy (PVR) and macular detachment at the time of surgery. Results: Overall retinal re-detachment rate was 10.1%. The main reason for re-detachment was an insufficient retinopexy in 53.6%, followed by PVR (37.3%), and retinal detachment occurred at a different location caused by another break in 9.1%. No significant difference in the rate of re-detachment was found if a phacoemulsification with simultaneous IOL implantation was performed (p = 0.641). No significant difference between the various retinopexy techniques was found (p = 0.309). Risk factors re-detachment were primary PVR (p = 0.0003), silicone oil as initial tamponade (p = 0.0001) as well as macula off detachments (p = 0.034). Conclusions: The present study showed no significant difference between the types of retinopexy and if additional phacoemulsification was performed or not. Factors associated with a higher risk for re-detachment were detached macula at surgery, primary PVR and primary oil-filling.


2020 ◽  
Author(s):  
Yifan Zhou ◽  
Siqi Zhang ◽  
Min Gao ◽  
Hao Zhou ◽  
Haiyun Liu ◽  
...  

Abstract Purpose: To investigate different fundus vasculature and structure changes after single pars plana vitrectomy (PPV) following silicone oil (SO) or sterilized air in macular-off rhegmatogenous retinal detachment (RRD) patients. Method: 39 eyes (39 patients) with macular-off RRD underwent standard three-port 23-gauge PPV and intraocular SO or gas tamponade. Optical Coherence Tomography (OCT) and angiography were used to evaluate fundus structure and vasculature including retinal layers thicknesses and vessel density (VD) changes throughout observation for 12 weeks. Retinal layers were segmented into: NFL, GCL+IPL, INL, OPL, ONL+IS, OS+RPE and BRM. Fundus vasculature was segmented into superficial and deep capillary plexus (SCP, DCP), and choriocapillaris plexus (CCP). Result: For fundus vasculature, SO tamponade led to significant decrease in both SCPVD and DCPVD, while only SCPVD was found significantly decreased in gas tamponade eyes. For specific retinal layer, SO led to significant decrease in NFL and INL thicknesses. OPL, ONL+IS and OS+RPE thicknesses had significant increase in both SO tamponade and gas tamponade eyes. Conclusion: Different intraocular tamponades could have various impacts on retinal vasculature and structure. Compared to sterilized air, silicone oil tamponade could have relatively more negative effects on retinal vasculature and specific retinal layer thickness change.


2020 ◽  
Author(s):  
Jipeng LI ◽  
Jun XU ◽  
Meng ZHAO

Abstract BACKGROUND The precise pre-operative measurements of axial length (AL) are essential for calculating intraocular lens power in cases undertaking pars plana vitrectomy (PPV) combined with cataract surgery. The changes in AL after PPV for rhegmatogenous retinal detachment (RRD) combined with choroidal detachment (CD) has not been reported. Here, we studied the postoperative AL changes in patients with RRD combined with CD (RRD-CD) and compared the changes in patients with RRD and tractional retinal detachment (TRD). METHODS In this retrospective cohort study, medical records of 129 patients who received PPV combined with silicone oil tamponade from January 2015 to December 2018 were reviewed. Patients included were divided into three groups, RRD-CD, RRD, and TRD. All patients had received AL measurements before PPV and before silicone oil removal (SOR). The changes in AL of three groups before PPV and before SOR were compared. The potential factors related to AL changes were analyzed. RESULTS The number of patients included in RRD-CD, RRD, TRD groups were 41, 43, and 45, respectively. In RRD-CD group, AL measured before SOR was longer than that measured before PPV with a median of 1.01 [0.37,1.79] mm (p = 0.02). There was no such significant difference in RRD group (0.15 [0.04, 0.42] mm, p = 0.58) or TRD group (0.07[-0.03,0.15] mm, p = 0.53). The amplitude of AL changes in RRD-CD group was greater than that in RRD group (p < 0.001) and that in TRD group (p < 0.001). AL increased 0.06 mm (0.06, R2 = 0.11, p = 0.03) in RRD-CD group and 0.02 mm (0.02, R2 = 0.11, p = 0.01) in RRD group when the IOP before SOR was 1 mmHg higher than that before PPV. After adjusting the effect of the factors as the presence of pathological myopia (p = 0.45), IOP before PPV (p = 0.86), sustained elevation of IOP in post-PPV follow up (p = 0.51), AL in RRD-CD group was 11.42 times (3.54, 46.80) more likely to increase for more than 1 mm compared to that in RRD group (p < 0.001, AIC = 86.15). CONCLUSION Patients with RRD-CD are very likely to have postoperative elongation of AL. The primary IOL implantation using pre-operative AL data may cause significant refractive error in combined surgery in patients with RRD-CD.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jie Li ◽  
Bo Zhao ◽  
Sanmei Liu ◽  
Fang Li ◽  
Wentao Dong ◽  
...  

Aim. To retrospectively compare the safety and effectiveness of 27-gauge (27G) microincision vitrectomy surgery (MIVS) with 25-guage (25G) MIVS for the treatment of primary rhegmatogenous retinal detachment (RRD) with silicone oil tamponade. Methods. Ninety-two patients with RRD who underwent MIVS from May 1, 2015, to June 30, 2017, were included in this study. Fifty-eight eyes underwent 25G MIVS and 34 eyes underwent 27G MIVS. We analyzed the characteristics of the patients, surgical time, main clinical outcomes, and rate of complications. Results. The mean surgical time was 56.7 ± 35.9 min for the 25G MIVS and 55.7 ± 36.1 min for the 27G MIVS, and there was no significant difference (P=0.894) between the two groups. The primary anatomical success rate after a single operation was 94.8% for 25G MIVS and 91.2% for 27G MIVS (P=0.666). Baseline and final visit best-corrected visual acuity (BCVA) were 1.9 ± 1.1 and 1.0 ± 0.8 in the 25G group, and 1.7 ± 1.0 and 1.1 ± 0.8 in the 27G group. Last visit BCVA increased significantly in both groups (P<0.001). However, there were no significant differences in terms of visual improvement ratio (>0.2 logMAR) between the two groups (P=0.173). No severe intraoperative complication was observed. Iatrogenic retinal breaks occurred in 2 eyes (3.4%) in the 25G group and 1 eye (2.9%) in the 27G group during the peripheral vitreous base shaving. The transient ocular hypertension (>25 mmHg) within postoperative week 1 was 25.9% in the 25G group and 11.8% in the 27G group (P=0.120). Conclusions. This study found no significant anatomical or functional difference between 27G and 25G MIVS in the treatment of primary RRD. Therefore, 27G vitrectomy appears to be a safe and effective surgery for the treatment of primary RRD.


2021 ◽  
Author(s):  
Ying Yan ◽  
Ran Liu ◽  
Chengyuan Gao ◽  
Yanping Song ◽  
Qin Ding ◽  
...  

Abstract PURPOSE: To investigate the effects of refractive accommodation on subfoveal choroidal thickness (SFCT) in silicone oil (SO)-filled eyes.METHODS: This retrospective, self-comparative study was conducted on 40 patients with unilateral macula-on rhegmatogenous retinal detachment, who underwent vitrectomy and SO tamponade. The SFCT of SO-filled eyes and the fellow control eyes were measured using optical coherence tomography at their one-month visit after surgery. The patients wore soft contact positive lenses for 24 hours in the SO-filled eyes, to correct their refractive error. SFCT and choroidal vascularity index (CVI) were measured before and after wearing the contact lenses. Mean SFCT was compared between SO-filled eyes and the fellow control eyes, and SFCT and CVI were compared before and after refractive error correction in the SO-filled eyes.RESULTS: Mean SFCT of SO-filled eyes (221.52±38.41 um) was less than that of the fellow eyes (273.41±31.30 um) (P<0.001). After refractive error correction, the mean SFCT increased to 269.28±36.90 um(P <0.001). However, CVI decreased from 57.01±2.41 to 55.39±2.39 (P<0.05).CONCLUSION: SFCT reduction in SO-filled eyes was primarily due to the hyperopia status. The non-uniform change in CVI suggests that changes in CT are mainly attributed to a greater expansion of the stromal area instead of the choroidal vascular area.


2021 ◽  
Vol 10 (22) ◽  
pp. 5436
Author(s):  
Jung Wook Lee ◽  
Heeyoon Cho ◽  
Min Ho Kang ◽  
Rimkyung Hong ◽  
Mincheol Seong ◽  
...  

This study aimed to evaluate and compare the retinal and choroidal thickness and vessel density (VD) changes between silicone oil (SO) tamponade and after SO removal using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). Thirty patients who underwent pars plana vitrectomy for retinal detachment (RD) with SO tamponade were included. SS-OCT and OCTA were conducted before RD surgery, during SO tamponade, and after SO removal. A 3-dimensional volumetric wide scan protocol was used for the analysis. The segmented retina, choroidal thickness map, and peripapillary thickness were then measured. For the OCTA analysis, 4.5 × 4.5 mm scans were used. Superficial and deep capillary plexus VDs in unaffected fellow eyes and eyes after SO removal were compared. During the SO tamponade period, the thickness of the parafoveal total retina, ganglion cell-inner plexiform layer, and peripapillary retinal nerve fiber layer (ppRNFL) were significantly thinner than those of unaffected fellow eyes (p < 0.05). The parafoveal layer thickness thinning recovered up to three to six months after SO removal. Moreover, six months after SO removal, the parafoveal thickness was not significantly different compared to that of unaffected fellow eyes (p > 0.05). However, the ppRNFL thickness was significantly decreased during SO tamponade and remained unrecovered six months after SO removal. There was no significant difference in the VD on the OCTA. Thus, SO tamponade and removal for RD resulted in a change in the retinal and peripapillary thickness. This may be due to the mechanical pressure effect of SO.


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