scholarly journals Intracameral anti-VEGF injection for advanced neovascular glaucoma after vitrectomy with silicone oil tamponade

2021 ◽  
Vol 14 (3) ◽  
pp. 456-460
Author(s):  
Ling Bai ◽  
◽  
Yi-Dan He ◽  
Shu Zhang ◽  
Feng Wang ◽  
...  
Keyword(s):  
Silicone Oil ◽  
Time Window ◽  
Neovascular Glaucoma ◽  
Optimal Time ◽  
Intracameral Injection ◽  
Pan Retinal Photocoagulation ◽  
Before And After ◽  
Silicone Oil Tamponade ◽  
Retinal Photocoagulation

AIM: To evaluate the effect of intracameral injection of conbercept for the treatment of advanced neovascular glaucoma (NVG) after vitrectomy with silicone oil tamponade. METHODS: Conbercept 0.5 mg/0.05 mL was injected into the anterior chamber of 5 eyes, which had developed advanced NVG after vitrectomy with silicone oil tamponade. Then, trabeculectomy with mitomycin C and pan-retinal photocoagulation (PRP) or extra-PRP were conducted within 2d. The follow-up time was 6mo. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), neovascularization of iris (NVI) were recorded before and after treatment. RESULTS: Within 2d after injection, IOP control, and NVI regression were optimal for trabeculectomy. Hyphema occurred in one eye in the process of injection. But none of them present hyphema after trabeculectomy. At the end of follow-up time, all eyes had improved BCVA, well-controlled IOP, and completely regressed NVI. CONCLUSION: Intracameral injection of conbercept is safe and effective in the treatment of patients with advanced NVG after vitrectomy with silicone oil tamponade. Within 2d after injection is the optimal time window for trabeculectomy, which can maximally reduce the risk of perioperative hyphema.

scholarly journals The Optimization of an Anti-VEGF Therapeutic Regimen for Neovascular Glaucoma

2022 ◽  
Vol 8 ◽  
Author(s):  
Ling Bai ◽  
Yanfen Wang ◽  
Xindi Liu ◽  
Yuping Zheng ◽  
Wenjing Wang ◽  
...  
Keyword(s):  
Mitomycin C ◽  
Neovascular Glaucoma ◽  
Stage Iii ◽  
Safety And Efficacy ◽  
Corrected Visual Acuity ◽  
Intracameral Injection ◽  
Pan Retinal Photocoagulation ◽  
Three Stages ◽  
To Receive ◽  
Retinal Photocoagulation

This study investigates the safety and efficacy of conbercept injection through different routes for neovascular glaucoma (NVG) treatment, in which seventy-four patients (81 eyes) with NVG caused by ischemia retinopathy had participated. Patients were divided into three stages according to the progression of NVG and were randomly assigned to receive intracameral or intravitreal conbercept injection. After conbercept injection, patients experienced improved best-corrected visual acuity (BCVA), good intraocular pressure (IOP) control, and neovascularization of Iris (NVI) regression. In stage III, patients required trabeculectomy with mitomycin C plus pan-retinal photocoagulation (PRP) to achieve complete NVI regression. Compared to the intravitreal group, the intracameral group had significantly lower IOP in 2 days in stage III and 1 day in stages I and II after injection, complete NVI regression before PRP in stages I and II, and better NVI regression in stage III. The rates of hyphema after trabeculectomy and malfunction filtering bleb suffering needle bleb revision were lower in the intracameral group, but only the hyphema rate was significantly different. Injections through different routes are all safe. We recommend intravitreal injections for patients in stages I and II, but for stage III, intracameral injection is better, and trabeculectomy with mitomycin C should be conducted within 2 days after injection to maximally reduce the risk of perioperative hyphema.Trial Registration:ClinicalTrials.gov, identifier NCT03154892.

scholarly journals Biometric changes after vitrectomy with silicone oil tamponade

2021 ◽  
Vol 2 (2) ◽  
pp. 56-62
Author(s):  
Simin Hosseini ◽  
Amir Faramarzi ◽  
Siamak Moradian ◽  
Mehdi Yaseri
Keyword(s):  
Silicone Oil ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Biometric Data ◽  
Cavity Depth ◽  
Time Points ◽  
Biometric Parameters ◽  
Before And After ◽  
Silicone Oil Tamponade

Background: The Lenstar LS 900 (Haag-Streit AG, Koeniz, Switzerland) is an optical biometer, and its measurements are highly repeatable and precise in cataractous eyes. This study investigated changes in biometric parameters, including axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous cavity depth (VD), and central corneal thickness (CCT) before and after three-port 23-Gauge pars plana vitrectomy with silicone oil tamponade. Methods: This was a prospective follow-up study. Patients who were scheduled for surgery underwent a detailed slit-lamp examination and objective cycloplegic refraction preoperatively. In eligible cases, the Lenstar LS 900 was used to measure biometric parameters. At the 1-month postoperative follow-up, we repeated the same assessments for the silicone oil (SO)-filled eyes. Data were analyzed to assess the significance of changes and to test the possible correlation of values between the two time points. Results: Twenty-three patients with a mean ± SD age of 60 ± 12 years completed the study. Postoperatively, we found a significant increase in AL and a decrease in ACD and CCT (all P < 0.05), with no significant changes in LT and VD. A significant correlation was found for ACD, CCT, and cylinder values between the two time points (all P < 0.05). Postoperatively, the spherical and cylindrical components of refraction demonstrated a hyperopic shift, but did not change statistically significantly. Conclusions: The Lenstar LS 900 underestimated the ACD and overestimated the AL in SO-filled eyes when comparing pre- and postoperative values, in phakic as well as pseudophakic eyes. In planning for cataract surgery in this group of patients, it is more reasonable to calculate IOL power based on the biometric data of the fellow eye, although this may not eliminate possible errors. Further studies with a larger sample size, longer follow-up, and robust study design are necessary to confirm our preliminary results.

scholarly journals Subthreshold Pan-retinal Photocoagulation Using Endpoint Management Algorithm for Severe Non-proliferative Diabetic Retinopathy: A Paired Controlled Pilot Prospective Study

2020 ◽  
Author(s):  
Kunbei Lai ◽  
Hongkun Zhao ◽  
Lijun Zhou ◽  
Chuangxin Huang ◽  
Xiaojing Zhong ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Outcome Measures ◽  
Proliferative Diabetic Retinopathy ◽  
Controlled Trial ◽  
Alternative Treatment Option ◽  
Pan Retinal Photocoagulation ◽  
Risk Of Progression ◽  
One Year ◽  
Retinal Photocoagulation

Purpose: To report the efficacy and safety profile of subthreshold pan-retinal photocoagulation (PRP) using endpoint management (EPM) algorithm compared with conventional threshold PASCAL PRP for the treatment of severe non-proliferative diabetic retinopathy (NPDR). Methods: This was a prospective, single center, paired randomized controlled trial of fifty-six eyes of twenty-eight participants with bilateral symmetric severe NPDR. One eye of the participant was randomly assigned to receive the subthreshold EPM PRP, while the other eye of the same participant received the threshold PASCAL PRP. The primary outcome measures included the difference in the one-year risk of progression to PDR between two groups, and mean changes of the logarithm of the minimal angle of resolution (logMAR) visual acuity (VA). The second outcome measures included central foveal thickness (CFT), one-year risk of progression to PDR, and visual field (VF) parameters. Results: The subthreshold EPM PRP group and the threshold PASCAL PRP group had similar one-year risk of progression to PDR during the 12-month follow-up visits (17.86% vs 14.29%, P>0.05). Slightly decreased VA was found in both groups (0.08 vs 0.09 logMAR VA), however, no statistical difference was found for neither group (P>0.05). Similar results were found for thickened CFT for both groups (23.59μm vs 28.34μm, P>0.05). Specifically, although substantial loss of VF was found in the threshold PASCAL PRP group (P<0.05), no obvious damage to VF was seen in the subthreshold EPM PRP group (P>0.05). Conclusion: The subthreshold EPM PRP is non-inferior to the conventional threshold PASCAL PRP in the treatment of severe NPDR during 12-month follow-up and could be an alternative treatment option for patients with severe NPDR.

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.

scholarly journals Posttraumatic Bacillus cereus Endophthalmitis: Clinical Characteristics and Antibiotic Susceptibilities

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Feng Mei ◽  
Jiaqi Lin ◽  
Manli Liu ◽  
Yao Yang ◽  
Xiaofeng Lin ◽  
...  
Keyword(s):  
Bacillus Cereus ◽  
Clinical Characteristics ◽  
Silicone Oil ◽  
Case Series ◽  
Visual Outcomes ◽  
Antibiotic Susceptibilities ◽  
Therapeutic Measures ◽  
Silicone Oil Tamponade ◽  
Better Than

Purpose. To report the clinical characteristics, antibiotic susceptibilities, and visual outcomes of patients with posttraumatic endophthalmitis caused by Bacillus cereus. Methods. In this retrospective, noncomparative case series, the medical records of eyes with culture-proven Bacillus cereus endophthalmitis treated from January 2016 to December 2019 at a referral center were reviewed. Clinical features, antibiotic susceptibilities, and visual outcomes were assessed. Results. A total of 19 eyes of 19 patients were identified. Three patients progressed to orbital cellulitis. Vitrectomy was performed in 13 eyes, and 11 required silicone oil tamponade. Finally, seven eyes underwent silicone oil removal surgery during follow-up. Only two patients retained a visual acuity better than FC. Four patients underwent evisceration, and three patients had NLP. The cultured Bacillus cereus was sensitive to levofloxacin, ofloxacin, tobramycin, and neomycin at 100%. Conclusions. The visual outcomes of posttraumatic Bacillus cereus endophthalmitis were generally poor regardless of the prophylactic and therapeutic measures administered. Vitrectomy combined with silicone oil tamponade could help to save the eyeball. Bacillus cereus has a good susceptibility to ofloxacin, levofloxacin, tobramycin, and neomycin; therefore, fluoroquinolones and aminoglycosides can be used to treat Bacillus cereus infection.

Outcome of Temporary Silicone Oil Tamponade in Complex Rhegmatogenous Retinal Detachment

2003 ◽  
Vol 13 (5) ◽  
pp. 474-481 ◽  
Author(s):  
A.M. Abu El-Asrar ◽  
S.M. Al-Bishi ◽  
D. Kangave
Keyword(s):  
Silicone Oil ◽  
Negative Impact ◽  
Penetrating Trauma ◽  
Visual Outcome ◽  
Macular Holes ◽  
Good Visual Outcome ◽  
Retinal Tears ◽  
Suprachoroidal Hemorrhage ◽  
Silicone Oil Tamponade

Purpose To evaluate the anatomic and visual outcomes and complications of temporary silicone oil (SO) retinal tamponade in patients with complex rhegmatogenous retinal detachments (RD). Methods The retrospective study included 100 eyes of 93 consecutive patients. Indications for the use of SO were proliferative vitreoretinopathy (PVR) (30 eyes), difficult RD (30 eyes), giant retinal tears (17 eyes), RD after penetrating trauma (14 eyes), and macular holes in highly myopic eyes (9 eyes). Vitrectomy surgery was performed with 5000-centistoke SO as the retinal tamponade. All eyes underwent prophylactic 360° retinopexy at the time of the retinal reattachment operation. The mean duration of SO tamponade was 26.4 weeks, with a mean follow-up of 67.5 weeks after removal of SO. Results In 6 of 100 eyes (6%), the retina redetached after removal of SO. Including the successfully reoperated eyes, the final anatomic success rate was 96%. Other complications were cataract (61%), increased intraocular pressure (13%), hypotony (4%), keratopathy (4%), intravitreal hemorrhage (1%), and suprachoroidal hemorrhage (1%). Corespondence analysis demonstrated that redetatchment and hypotony were associated with PVR and trauma. Overall, good visual outcome (20/200 or better) was achieved in 51% of the whole study group, and in 70.6% of eyes with giant tears, 62.1% of eyes with difficult RD, 44.8% of eyes with PVR, 33.3% of eyes with macular holes, and 28.6% of eyes with trauma (p=0.0382). Logistic regression analysis identified initial visual acuity of 20/200 or better as a factor associated with good visual outcome and occurrence of retinal redetachment/hypotony and old age (≥50 years) as factors negatively associated with good visual outcome. Conclusions The low redetachment rate might be due to prophylactic 360° retinopexy. Giant tears had the best visual outcome. Redetachment/hypotony had a negative impact on achievement of good visual outcome and were associated with PVR and trauma.

scholarly journals Ocular biometry and refractive changes post sutureless vitrectomy surgery

2019 ◽  
Vol 1 (2) ◽  
pp. 114-125
Author(s):  
Raja nor farahiyah Raja othman
Keyword(s):  
Silicone Oil ◽  
Anterior Chamber Depth ◽  
Ocular Biometry ◽  
Myopic Shift ◽  
Before And After ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
The Mean ◽  
23 Gauge ◽  
Patients Experience

Introduction: Pars plana vitrectomy (PPV) without endotamponade should not induce significant change to the refractive status of the eye. However, several studies have reported minor refractive changes after plain vitrectomy. Purpose: To compare the changes in refraction following PPV and to examine the biometry parameters that may affect the refractive change.Materials and methods: In this prospective cohort study, patients who were listed for 23-gauge 3-port PPV without buckling or silicone oil tamponade were enrolled between December 2015 and September 2017. Autorefraction, keratometry, anterior chamber depth (ACD), and axial length (AL) were measured preoperatively and three months postoperatively.Results: This study involved 41 eyes from 38 patients. The mean spherical equivalent (SE) before PPV was -1.08 dioptres (D), (standard deviation (SD) 2.18), which changed to a mean of -1.88 D (SD 2.20) postoperatively. The mean SE change was -0.80 D (SD 1.61, 95% confidence interval (CI) -1.31 to 0.30 D, P = 0.003). The median astigmatism before PPV was 0.69 D (Interquartile range (IQR) 0.69 D) reduced to 0.66 D (IQR 0.60 D) after PPV (P = 0.882). Median ACD preoperatively was 3.55 mm (IQR 0.76 mm) and reduced postoperatively to 3.44 mm (IQR 0.67 mm), (P = 0.028). The median AL was 23.36 mm (IQR 1.42 mm) and 23.48 mm (IQR 1.56 mm) before and after PPV, respectively, (P = 0.029). No significant SE change was found between phakic and pseudophakic groups (P = 0.155).Conclusion: Patients experience myopic shift post plain PPV, possibly due to the reduction of ACD. The ACD tended to be shorter in the pseudophakic group, suggesting that the myopic shift in the phakic group may be a result of the development of nuclear sclerosis cataract.

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