scholarly journals New technique for removal of perfluorocarbon liquid related sticky silicone oil and literature review

2021 ◽  
Vol 14 (12) ◽  
pp. 1903-1908
Author(s):  
Hai-Shuang Lin ◽  
◽  
Lu Zhang ◽  
En-Ze Liu ◽  
Ling-Ying Ye ◽  
...  

AIM: To investigate the safety and efficacy of sticky silicone oil (SSO) removal using a 22-gauge vein detained needle and inner limiting membrane (ILM) wrap-and-peel technique. METHODS: This retrospective consecutive case series reviewed the records of patients with a history of retinal detachment who had received silicone oil and perfluorocarbon liquid (PFCL) as intraocular tamponades. Patients were included in the analysis if they exhibited SSO remnants during silicone oil removal. The aspiration of most of the SSO remnants was performed by a 22-gauge vein detained needle. The small amounts of droplets adhered to the macula and epi-macular membrane were subsequently removed by the ILM warp-and-peel technique. The anatomical and functional outcomes, and postoperative complications were recorded. In vitro experiments were performed to simulate the formation of SSO remnants in four groups. RESULTS: Of 711 patients who underwent silicone oil removal during the study period, 9 patients exhibited SSO remnants and underwent follow-up for at least 3mo. Seven eyes (78%) underwent the ILM wrap-and-peel technique to completely remove small droplets of SSO that were glued to the macula and epi-macular membrane. No obvious complications occurred. Postoperative optical coherence tomography revealed normal retinal structure in all patients. In vitro analyses showed that balanced salt solution and prolonged vibration (for 1wk) had the strongest effects on silicone oil and PFCL compound opacities. CONCLUSION: SSO remnants could be removed in an intact manner and without complications, using a vein detained needle-assisted and ILM wrap-and-peel technique. The findings suggest that PFCL and infusion fluid should be completely removed before silicone oil injection to prevent SSO formation.

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hammouda Hamdy Ghoraba ◽  
Sameh Mohamed Elgouhary ◽  
Hosam Osman Mansour

Purpose. To evaluate the efficacy of silicone oil (S.O) reinjection without macular buckling for treatment of recurrent myopic macular hole retinal detachment (MHRD) after silicone oil removal.Methods. A retrospective consecutive interventional study from medical reports on cases of myopic MHRD. Fifty-three eyes of 51 patients underwent silicone oil removal after successful repair of MHRD were reviewed. The main outcomes were the retinal status after silicone oil removal and management of recurrent cases.Results. The rate of recurrent RD (Re RD) after silicone oil removal was 11.3% (6 out of 53 eyes). One case refused any other interference. In the remaining 5 eyes, 4 eyes (80%) could be reattached by S.O re-injection and one eye (20%) developed Re RD after S.O re-injection. Range of followup after management of recurrence was 5–53 months (mean 18.7 months).Conclusions. This case series concluded that the risk factors for recurrent RD after silicone oil removal from cases of myopic MHRD were high myopia, open flat MH, and large posterior staphyloma. Revision of vitrectomy and S.O re-injection can reattach most of recurrent cases.


2019 ◽  
Vol 30 (1) ◽  
pp. 224-228
Author(s):  
Wael Soliman ◽  
Tarek A Mohamed ◽  
Khaled Abdelazeem ◽  
Mohamed Sharaf

Aim: The aim of this study was to study the safety and efficacy of posterior capsulorhexis in vitrectomized eyes undergoing combined phacoemulsification or irrigation/aspiration and silicone oil removal. Methods: This prospective non-randomized interventional study involved 115 silicone-filled eyes of 115 previously vitrectomized patients. All patients underwent combined phacoemulsification or underwent irrigation/aspiration and silicone oil removal, followed by foldable intraocular lens implantation combined with primary posterior trans-scleral capsulorhexis. A 23-gauge trans-scleral vitrectomy probe was used to form the posterior capsulorhexis (vitrectorhexis). Patients were followed for 6 months. Results: Intraocular lenses maintained good centration in the capsular bag during and after trans-scleral posterior capsulorhexis. No complications were observed in the postoperative period regarding lens centration or size of the posterior capsulorhexis. No included eyes needed YAG laser posterior capsulotomy and no recurrent retinal detachment was reported during follow-up. Conclusion: Performing primary trans-scleral capsulorhexis in patients undergoing combined phacoemulsification, or irrigation/aspiration and silicone oil removal, enabled achievement of an early postoperative clear visual axis and prevented the onset of dense postoperative posterior capsular opacification in previously silicone-filled eyes. This technique is reproducible and may facilitate additional intra-operative procedures and uncomplicated postoperative follow-up of retinal detachment patients without requiring YAG laser capsulotomy.


1998 ◽  
Vol 76 (2) ◽  
pp. 192-195 ◽  
Author(s):  
Christoph D. Scholda ◽  
Stefan F. Egger ◽  
Adalbert Lakits ◽  
Ilse Steffan ◽  
Isabella Baumgartner ◽  
...  

Author(s):  
Amr Mohammed Elsayed Abdelkader ◽  
Hossam Youssef Abouelkheir

Abstract Background To evaluate the effectiveness of face up position (FUP) following pars plana vitrectomy (PPV) and silicone oil injection in cases of rhegmatogenous retinal detachment (RRD) with multiple peripheral and inferior breaks. Method Thirty-two eyes of 32 patients with RRD due to multiple peripheral breaks were managed with PPV and silicone oil as endotamponade. Postoperatively, all patients were instructed to assume face up (supine) position for at least 10 days. Silicone oil was removed 3 to 6 months postoperatively in eyes with attached retina and the patients were followed up for 6 months. Results Thirty eyes (94%) got a successful attachment of the retina and remained attached after silicone oil removal. One case showed lower redetachment under silicone oil while the other case showed recurrent RRD after silicone oil removal. Conclusion Although postoperative FUP is not a popular one, it is effective in the treatment of RRD with peripheral breaks whatever the number or the distribution of these breaks. This may in some way or another change the traditional trends of postoperative positioning after vitrectomy for RRD.


2021 ◽  
Vol 12 (12) ◽  
pp. 39-43
Author(s):  
Fevzi Akkan ◽  
Dincer Dinc

Background: Silicone oil, which is one of the most commonly used endotamponades in vitreoretinal surgery, is removed after a certain period of time in most cases. In this study, we present our results with a unique cannula that provides effective and safe silicone oil removal. Aims and Objectives: To assess the aids and success of silicone oil removal with a novel 23-gauge cannula for the patients who underwent pars plana vitrectomy and silicone oil injection before. Materials and Methods: 72 eyes of 64 patients who operated by the same surgeon (FA) between May 2017 and May 2019 were involved in the study. The primary indications were proliferative diabetic retinopathy in 46 (63.9%) eyes and retinal detachment in 26 (36.1%) eyes. Phacoemulsification and intraocular lens implantation (23 eyes), membrane peeling (23 eyes), internal limiting membrane peeling (5 eyes), and argon laser endo-photocoagulation (37 eyes) performed in the same session. Furthermore, perfluorocarbon remnants aspirated in 9 eyes and 17 eyes needed suturing. Descriptive statistical analyses achieved by SPSS 10.5 statistical software. Results: The mean follow-up time was 11.7 + 2.5 months (between 3 and 23 months), and the mean age was 61.4 + 8.52 years (between 44 and 69 years). 1000 centistokes (cSt) silicone oil was removed from 61 (84.7%) eyes, and 5000 cSt silicone oil was removed from 11 (15.3%) eyes. The mean removal time was 2.04 + 0.1 min for 1000 cSt silicone oil and 5.11 + 0.3 min for 5000 cSt silicone oil. 4 re-detachment and 3 vitreous hemorrhage observed in follow-up period. Post-operative silicone oil remnants were not detected in any patient. Conclusion: The unique 23-gauge cannula provides silicone oil removal without any conjunctival cut-down and sclerotomy enlargement. Thus, it reduces the duration of surgery and post-operative recovery period.


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

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.  


2020 ◽  
pp. 112067212097603
Author(s):  
Gökhan Gürelik ◽  
Sabahattin Sül ◽  
Ahmet Yücel Üçgül

Purpose: To evaluate the anatomic and visual outcomes of a new intraocular mitomycin c (MMC) application technique in the treatment of severe traumatic retinal detachment (RD) with advance proliferative vitreoretinopathy (PVR). Methods: The records of 15 eyes of 14 patients who underwent vitreoretinal surgery and intraoperative MMC application were reviewed retrospectively. Surgical technique: After performing complicated vitreoretinal surgical procedures (Pars plana vitrectomy, PVR membrane stripping, large retinotomy/retinectomies and intraocular foreign body removal if found etc. . .) retina was attached with perfluorocarbon liquid (PFCL) and partial fluid-air exchange. Endolaser was performed. PFCL was removed to the posterior borders of retinochoroidal wounds, breaks or retinectomy sites. The remaining PFCL was enough to cover and prevent MMC contact with the posterior vital structures including optic disc, macula and underlying RPE and major vascular arcades. Ciliary epithelium and other anterior segment structures were protected from MMC contact with the use of air in the rest of the eye. Then, a 10 µg/mL concentrated MMC solution was carefully injected above the PFCL bubble until it covered PVR or potential areas of PVR development and removed after 60 s. Finally, the remaining PFCL was removed and all eyes were filled with silicone oil. The patients were followed at least 6 months after silicone oil removal. Visual and anatomic outcomes were determined during follow-up period. Results: The mean follow-up time was 19.6 ± 6 months (range 12–27 months). About 100% retinal attachment was achieved with one vitreoretinal surgery during the follow-up period. PVR was not detected around the retinal breaks or retinotomy sites in any eye. Limited macular epiretinal membrane was detected in two eyes and subsequently peeled during silicone oil removal. Preoperative visual acuities were hand motions in seven eyes and light perception in eight eyes. Nine of 15 eyes had a visual acuity of ⩾0.1 during the follow-up period. The mean preoperative visual acuity was logMAR 2.16 ± 0.15 and postoperative visual acuity was 0.80 ± 0.50 ( p = 0.001). There were no additional complications related to intraoperative MMC use during follow-up period. Conclusion: Temporary intraocular MMC use in vitreoretinal surgery yielded good anatomic and visual outcomes after the treatment of traumatic RDs with PVR or those with high risk of PVR development. Furthermore, MMC application appeared to prevent further PVR development after vitreoretinal surgery.


Author(s):  
A.M. Danilov ◽  
◽  
A.G. Grinev ◽  
M.B. Sviridova ◽  
◽  
...  

Актуальность. Тампонада витреальной полости силиконовым маслом (СМ) или наличие остатков СМ при авитрии являются показаниями к их удалению, которое может быть выполнено различными методиками, нередко после факоэмульсификации катаракты. Цель. Изучить результаты удаления СМ через задний капсулорексис (ЗК) различными методами. 1. Изучить возможность удаления остатков СМ через задний капсулорексис при авитрии. 2. Провести апробацию удаления СМ через ЗК методом эффузии. 3. Провести апробацию удаления СМ через ЗК методом аспирации. Материал и методы. Под наблюдением находилось 18 пациентов, проходивших лечение в СОКБ №1. Результаты. Операции выполнены без осложнений в ближайшем и отдаленном послеоперационном периоде с улучшением зрительных функций. Выводы. 1. Изучены результаты удаления СМ через задний капсулорексис. 2. Удаление остатков СМ через ЗК при авитрии после факоэмульсификации позволяет повысить степень удовлетворенности пациентов результатами хирургического лечения. 3. Проведена апробация удаления СМ через ЗК методом эффузии, что позволяет качественнее удалять СМ, в том числе эмульгированные фрагменты. 4. Проведена апробация удаления СМ через ЗК методом аспирации, что сокращает время операции, позволяет в большем объеме удалять остатки эмульгированного СМ.


2021 ◽  
pp. 112067212110128
Author(s):  
Mumin Hocaoglu ◽  
Murat Karacorlu ◽  
M. Giray Ersoz ◽  
Isil Sayman Muslubas ◽  
Serra Arf

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.


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