scholarly journals Phacoemulsification of primary cataract by the second stage after vitreoretinal surgery of PDR patients.

2021 ◽  
Vol 23 (5) ◽  
pp. 452-458
Author(s):  
Karina Igorevna Konovalova ◽  
Mikhail Mikhailovich Shishkin ◽  
Rinat Rustamovich Fayzrakhmanov
Keyword(s):  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Second Step ◽  
Oil Removal ◽  
Iol Implantation ◽  
Second Stage ◽  
Silicone Oil Removal ◽  
Silicone Oil Tamponade ◽  
Group 2 ◽  
Group 1

BACKGROUND: The «gold standart» for surgical treatment of patients with proliferative diabetic retinopathy (PDR is vitreoretinal surgery. However, the question of the timing of the removal of primary cataract in this category of patients remains open.AIM: To evaluate the efficacy of phacoemulsification of primary cataract by the second stage after vitreoretinal surgery of PDR patientsMETHODS: 67 cases of surgery treatment of patients with PDR and complicated primary cataract were enrolled. This patients were divided into two groups depending on the treatment tactics. In the 1st group patients were subjected to a two–step surgical procedure: vitreoretinal surgery with silicone oil tamponade performed as the 1st step in their treatment; followed by the 2d step, phacoemulsifi tion surgery and silicone oil removal, and the IOL implantation, respectively. In the 2d group phacoemulsifi tion performed simultaneously with vitreoretinal surgery: phacoemulsification, IOL implantation, vitreoretinal surgery with silicone oil tamponade. The second step differed in the removal of silicone oil from the vitreous cavity.RESULTS: Visual functions improved in 88.6% of cases in group 1, and in 68.7% in group 2.CONCLUSIONS: Outcomes of the preliminary studies suggest that it is more viable to perform phacoemulsification surgery sometime later along with silicone oil removal on PDR patients with complicated primary cataract. This sequence of treatment procedure ensures a more gentle approach to the anatomic structures of the eye during the first stage (vitreoretinal surgery) and contributes to the reduction in the number of intraoperative and postoperative complications.

Changes of the level of pro- and anti-inflammatory cytokines in tear of patients with advanced proliferative diabetic retinopathy and complicated primary cataract depending on the volume vitreoretinal surgery

2021 ◽  
pp. 82-86
Author(s):  
K.I. Konovalova ◽  
◽  
M.M. Shishkin ◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Inflammatory Cytokines ◽  
Proliferative Diabetic Retinopathy ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Second Step ◽  
Iol Implantation ◽  
Keywords Cytokines ◽  
Silicone Oil Tamponade ◽  
Anti Inflammatory

Purpose. The aim is to estimate the content of pro- and anti-inflammatory cytokines (IL-1β, IL-8, IL-10, MCP-1, ICAM-1, VEGF) in tear of patients with advanced proliferative diabetic retinopathy and complicated primary cataract after phacoemulsification surgery and IOL implantation with vitreoretinal surgery accomplished at once in comparison with vitreoretinal surgery only. Material and methods. 34 cases of surgery treatment of patients with PDR and complicated primary cataract were enrolled. This patients were divided into two groups depending on the treatment tactics. In the 1st group patients were subjected to a two–step surgical procedure: vitreoretinal surgery (VRS) with silicone oil tamponade performed as the 1st step in their treatment; followed by the 2nd step, phacoemulsification surgery and silicone oil removal, and the IOL implantation, respectively. In the 2nd group phacoemulsification performed simultaneously with vitreoretinal surgery: phacoemulsification, IOL implantation, vitreoretinal surgery with silicone oil tamponade. The second step differed in the removal of silicone oil from the vitreous cavity. On the 2nd day after the 1st step surgery and before surgical treatment the tear samples of the patients of both groups have been examined. Results. A concentration of the following cytokines: IL-8, MCP-1, ICAM-1 in the 2nd group was 2,5-5 times higher than in the 1st group. Conclusion. The research revealed that the patients with advanced PDR are accurately determined by the increased concentration of IL-8, MCP-1, ICAM-1 in tear after phacoemulsification surgery and IOL implantation with vitreoretinal surgery accomplished at once in comparison with vitreoretinal surgery only. Keywords: cytokines, diabetic retinopathy, cataract, vitreoretinal surgery.

Long-term results of two-stage surgical treatment of patients with advanced proliferative diabetic retinopathy and complicated incipient cataract

2021 ◽  
pp. 100-104
Author(s):  
K.I. Konovalova ◽  
◽  
M.M. Shishkin ◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Surgical Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Long Term Results ◽  
Oil Removal ◽  
Iol Implantation ◽  
Silicone Oil Tamponade

Purpose. To compare and evaluate long-term results of two-stage surgical treatment of patients with advanced proliferative diabetic retinopathy and complicated incipient cataract. Material and methods. 73 patients with advanced proliferative diabetic retinopathy and complicated incipient cataract performed by vitrectomy from 2016 to 2020 were analyzed. In the 1st group patients were subjected to a two-step surgical procedure: vitreoretinal surgery with silicone oil tamponade performed as the 1st step in their treatment; followed by the 2d step, phacoemulsification surgery and silicone oil removal, and the IOL implantation, respectively. In the 2d group phacoemulsification performed simultaneously with vitreoretinal surgery: phacoemulsification, IOL implantation, vitreoretinal surgery with silicone oil tamponade. The second step differed in the removal of silicone oil from the vitreous cavity. Results. Visual functions improved in 88.8% of cases in group 1, and in 51.3% in group 2. Conclusion. Outcomes of the studies suggest that it is more viable to perform phacoemulsification surgery sometime later along with silicone oil removal on PDR patients with complicated primary cataract. This sequence of treatment procedure ensures a more gentle approach to the anatomic structures of the eye during the first stage (vitreoretinal surgery) and contributes to the reduction in the number of intraoperative and postoperative complications. Key words: diabetic retinopathy, cataract, vitreoretinal surgery.

scholarly journals Effect of Duration of Silicone Oil Tamponade on Retinal Structure after Rhegmatogenous Retinal Detachment Surgery

2021 ◽  
pp. 1-8
Author(s):  
Chloé Dubroux ◽  
Julia Salleron ◽  
Karine Angioi-Duprez ◽  
Jean-Paul Berrod ◽  
Jean-Baptiste Conart
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Case Series ◽  
Retinal Layer ◽  
Before And After ◽  
Silicone Oil Tamponade ◽  
Group 2 ◽  
Change In Mean ◽  
Group 1

<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.

Macular Effects of Silicone Oil Tamponade: Optical Coherence Tomography Findings During and After Silicone Oil Removal

2016 ◽  
Vol 42 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Danielle M. Lo ◽  
Christina J. Flaxel ◽  
Amani A. Fawzi
Keyword(s):  
Optical Coherence Tomography ◽  
Silicone Oil ◽  
Optical Coherence ◽  
Oil Removal ◽  
Silicone Oil Removal ◽  
Silicone Oil Tamponade

scholarly journals Intraocular silicone oil removal: timing, outcome, and silicone oil complications encountered

2019 ◽  
Vol 1 (1) ◽  
pp. 37-49
Author(s):  
Nurul Shima Ismail ◽  
Ling Kiet Phang ◽  
Teh Wee Min ◽  
Wan Haslina Wan Abdul Halim ◽  
Haslina Mohd Ali
Keyword(s):  
Silicone Oil ◽  
Optimal Timing ◽  
Oil Removal ◽  
Silicone Oil Removal ◽  
Long Duration ◽  
Number Of Patients ◽  
Pars Plana ◽  
Silicone Oil Tamponade

Introduction: Silicone oil is the preferred tamponade agent used in pars-plana vitrectomy for retinal detachment when a long duration of endotamponade is intended. Due to its possible long-term complications, removal of silicone oil (ROO) is recommended. Purpose: This study is done to evaluate the mean duration and complications of silicone oil tamponade, and the anatomical and visual outcomes after silicone oil removal. Study design: Retrospective study. Materials and methods: Retrospective review was done on 55 eyes of 55 patients, in which ROO was carried out at Hospital Sultanah Bahiyah in 2016 with a minimum six months follow-up postoperatively. Results: The duration of silicone oil tamponade in these eyes ranged from 1.0 to 55.5 months, with mean duration of 10.8 months (SD 7.74). Common complications of silicone oil tamponade observed were cataract in 30 eyes (54.5%), followed by secondary high intraocular pressure in 6 eyes (10.9%), and band keratopathy in 3 eyes (5.5%). Six eyes (10.9%) developed retinal re-detachment after oil removal.  The majority in the anatomically attached group post ROO (40 eyes, 81.6%) showed improvement of vision after ROO, with mean best corrected vision of LogMAR 1.38 (6/150) with silicone oil in situ to LogMAR 0.88 (6/48) at the latest follow-up. Conclusions: Although the recommended duration of silicone oil tamponade ranges from three to six months, the optimal timing for silicone oil removal still remains unknown. ROO is recommended due to oil-related complications, but the anatomical outcome should be evaluated as well. However, in our setting, with limited resources and time, and increasing number of patients indicated for silicone oil, it is impossible to comply with the recommended time for ROO and the timing is usually set on an individual basis.  

scholarly journals The Changes of Retinal Saturation after Long-Term Tamponade with Silicone Oil

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Bingsheng Lou ◽  
Zhaohui Yuan ◽  
Liwen He ◽  
Lixia Lin ◽  
Qianying Gao ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Silicone Oil ◽  
Oxygen Metabolism ◽  
Oil Removal ◽  
Silicone Oil Removal ◽  
Retinal Arterioles ◽  
Silicone Oil Tamponade ◽  
The Mean ◽  
Arteriovenous Difference

Purpose.To evaluate the effects of long-term tamponade with silicone oil on retinal saturation.Methods.A total of 49 eyes that received tamponade with silicone oil were included. The patients were divided into 3 groups (3–6 months, 6–9 months, and >9 months) according to the duration of silicone oil tamponade. Retinal oximetry was performed using the Oxymap system before and 2 months after silicone oil removal.Results.The mean retinal oxygen saturation before silicone oil removal was 107% ± 12% in the arterioles and 60% ± 10% in the venules, with an overall arteriovenous difference (AVD) of 47% ± 14%. The AVD in the >9-month group was significantly higher than that in the 3–6-month group (54% ± 16% versus 44% ± 11%,P=0.042). After silicone oil removal, the AVD in the >9-month group was significantly decreased (45% ± 9% versus 54% ± 16%,P=0.009); additionally, the arterioles were significantly wider than before surgery (10.8 ± 0.7 pixels versus 10.4 ± 0.9 pixels,P=0.015).Conclusions.The tamponade with silicone oil for more than 9 months will cause the alterations of retinal saturation and the narrowing of retinal arterioles, which may further interfere with the oxygen metabolism in the retina.

Ultrastructural effects of silicone oil on the clear crystalline lens of the human eye

2018 ◽  
Vol 28 (5) ◽  
pp. 566-572
Author(s):  
Wael Soliman ◽  
Mohamed Sharaf ◽  
Khaled Abdelazeem ◽  
Dalia El-Gamal ◽  
Allam Nafady
Keyword(s):  
Electron Microscopy ◽  
Epithelial Cells ◽  
Silicone Oil ◽  
Lens Epithelial Cells ◽  
Oil Removal ◽  
Electron Microscopic ◽  
Anterior Capsule ◽  
Lens Extraction ◽  
Silicone Oil Removal ◽  
Silicone Oil Tamponade

Purpose: To evaluate light and electron microscopic changes of the anterior capsule and its epithelium after clear lens extraction of vitrectomized myopic eyes with silicone oil tamponade. Methods: This prospective, controlled, non-randomized, interventional study included 20 anterior lens capsular specimens that were excised during combined clear lens extraction and silicone oil removal from previously vitrectomized highly myopic patients with silicone oil tamponade for previous retinal detachment surgeries. The specimens were examined via light microscopy and electron microscopy and compared with 20 anterior capsule specimens removed during clear lens extraction of non-vitrectomized highly myopic eyes. Results: Light microscopic examination of clear lens anterior capsule specimens of vitrectomized myopic eyes filled with silicone oil showed relatively more flat cells with irregular outline of lens’ epithelial cells with wide intercellular spaces, deeply stained nuclei, and multiple intracytoplasmic vacuoles. Scanning electron microscopy revealed collagenous surfaces filled with multiple pits, depressions, and abnormal deposits. Transmission electron microscopy revealed lens epithelial cells with apoptotic changes, many cytoplasmic vacuoles, and filopodia-like protrusions between lens epithelial cells and the capsule. Epithelial proliferation and multilayering were also observed. Conclusion: silicone oil may play a role in the development of apoptotic and histopathological changes in clear lens epithelial cells. Clarity of the lens at the time of silicone oil removal does not indicate an absence of cataractous changes. We found justification of combined clear lens extraction and silicone oil removal or combined phacovitrectomy when silicone oil injection is planned, but further long-term studies with larger patient groups are required.

scholarly journals Surgical Outcomes of Combined Phacoemulsification and Silicone oil Removal in Post Retinal Detachment Surgery Patients

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Uzma Haseeb ◽  
Muhammad Haseeb ◽  
Aziz Ur Rehman
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Surgical Outcomes ◽  
Silicone Oil ◽  
Time Interval ◽  
Oil Removal ◽  
Iol Implantation ◽  
Retinal Detachment Surgery ◽  
Silicone Oil Removal ◽  
Snellen Chart

Purpose:  To evaluate the surgical outcomes of Combined Phacoemulsification with IOL implantation and Silicone oil removal in patients with previous retinal surgery. Study Design:  Interventional case series. Place and Duration of Study:  Al-Ibrahim eye Hospital Karachi from January 2019 to December 2019. Methods:  Total 30 eyes of 30 patients between ages of 25 to 65 years, who had retinal detachment surgery with silicone oil used as internal tamponade and later on developed cataract were re-operated once confirming that retinal was attached. The time interval between two surgeries was 8 to 10 months. Phacoemulsification with IOL implantationwas done followed by silicone oil removal by 23-gauge pars plana method. Postoperative follow-ups were done at day 1, 1 month and at 6 months to record visual acuity and retinal status. Results:  Best corrected Visual acuity was recorded pre and post-operatively using Snellen chart.  Preoperatively 12 patients had visual acuity of 6/60, 12 with vision 6/95 and 6 with 6/120. There was improvement of 2 lines of visual acuity post operatively as recorded by Snellen chart. Retina was attached in 28 (93.33%) patients and 2 (6.66%) had re-detached retina at the end of 6 months. Conclusion:  Visual outcomes were found to be better with low rate of retinal re-detachment after 6 months follow-up of combined phacoemulsification with IOL implantation and silicone oil removal. Hence, Combined Phacoemulsification with Silicone oil removal is a method that is associated with better visual and anatomical outcomes as well as decrease the chances of patients undergoing third surgery for cataract extraction. Key Words:  Retinal Detachment, Phacoemulsification, Silicon Oil.

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