Surgery of cicatricial stage of choroidal neovascular membrane with autologous conditioned plasma

Purpose. To estimate the effectiveness of the cicatricial stage of choroidal neovascular membrane (CNM) surgery with retina fixation after retinotomy of paracentral areas with autologous conditioned platelet rich plasma (ACP) and without endolaser photocoagulation and silicone oil tamponade. Material and methods. 17 CNM patients aged 49 to 82 with visual acuity from 0.02 eccentric to 0.08 were operated. The operation consisted in 25-, 27+-gauge vitrectomy, removal of the posterior hyaloid membrane and the inner limiting membrane (in the presence of an epiretinal membrane), paracentral retinotomy, removal of the choroidal neovascular membrane via retinotomy, pneumoretinopexy, 2–3 layer instillation of ACP in the retinotomy area without endolaser photocoagulation and silicone oil tamponade, seamless closure of sclera- and conjunctivotomy with a layer of autologous conditioned plasma. Results. Full retinal reattachment and closure of the retinotomy opening in the late postoperative period was noted in all patients. No case of recurrent retinal detachment was recorded. Complete closure of sclera- and conjunctivotomy with no additional suture fixation was achieved in all cases. In the long-term period after the removal of the cicatricial choroidal membrane, visual acuity was 0.03–0.2. Conclusion. The modern surgery of the cicatricial stage of CNM using ACP to close the retinotomy defect after removal of cicatricial CNV without endolaser coagulation of the retina and silicone tamponade, followed by seamless blocking of the sclero- and conjunctivotomy with ACP produces excellent anatomical and functional results, minimizing the risk of postoperative complications.

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Long-Term Evaluation of Anatomic and Functional Results after Complicated Retinal Detachment Treated with Pars Plana Vitrectomy and Heavy Silicone Oil Tamponade

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/s-0028-1109685 ◽

2009 ◽

Vol 226 (09) ◽

pp. 707-712 ◽

Cited By ~ 7

Author(s):

R. Regler ◽

H. Sachs ◽

J. Hillenkamp ◽

H. Helbig ◽

C. Framme

Keyword(s):

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Functional Results ◽

Heavy Silicone Oil ◽

Term Evaluation ◽

Pars Plana ◽

Silicone Oil Tamponade

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Use of Autologous Conditioned Platelet Rich Plasma in the Surgery of Rhegmatogenous Retinal Detachment with Central and Peripheral Tears

Acta biomedica scientifica ◽

10.29413/abs.2019-4.4.8 ◽

2019 ◽

Vol 4 (4) ◽

pp. 61-65

Author(s):

D. G. Arsiutov

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Postoperative Period ◽

Rhegmatogenous Retinal Detachment ◽

Silicone Oil ◽

Platelet Rich Plasma ◽

Dentate Line ◽

Retinal Tears ◽

Retinal Reattachment ◽

Late Postoperative Period

Background. The method of the use of autologous conditioned platelet rich plasma is a promising method in the surgery of retinal pathology, particularly in the surgery of rhegmatogenous retinal detachment without the use of additional endolaser photocoagulation, but requires the foundation of its efficiency.Aim: to evaluate the effectiveness of the surgery of rhegmatogenous retinal detachment with central (macular) and peripheral retinal tears, including retinal abruption from the dentate line, with the use of 25, 27-gauge subtotal vitrectomy, pneumoretinopexy and silicone oil tamponade with blocking of retinal defect with the use of autologous conditioned plasma without the use of endolaser photocoagulation around retinal defects.Materials and methods. The surgery included 25, 27-gauge vitrectomy, posterior hyaloid membrane removal, internal limiting membrane removal in case of macular hole, pneumoretinopexy, instiilation in 2–3 layers of autologous conditioned platelet rich plasma, devoid of leukocytes and containing 1.5–3 times more thrombocytes than in whole blood into the area of retinal detachment or along the edge of retinotomy till the retinal defect and nearby intact retina are totally covered. A total of 29 patients with visual acuity from 0.03 to 1.0 underwent the surgery.Results. In the early postoperative period (up to 1 month) 96.6 % of patients showed total retinal reattachment, retinal detachment was blocked, in one patient with multiple retinal tears recurrent retinal detachment was detected; in the early delayed postoperative period (1–3 months) 82.8 % of patients showed total retinal reattachment, in 5 patient retinal reattachment was partial.In the late postoperative period (4–12 months) 86.2 % of patients showed total retinal reattachment, there were 4 recurrent retinal detachments. Patients with recurrent retinal detachment were successfully reoperated. Autologous conditioned plasma was not used during reoperations. Visual acuity of the patients, which underwent surgery in the late postoperative period, was 0.1–1.0.Conclusions. 25, 27-gauge vitreoretinal surgery of rhegmatogenous retinal detachment with central and peripheral retinal tears, including tears with abruption from the dentate line and retinal defects blocking with the use of autologous conditioned plasma rich with thrombocytes without the use of endolaser photocoagulation around retinal defects – is a method which allows to achieve in most cases total retinal reattachment, better functioning of the operated eye.

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Long-term silicone oil tamponade in eyes with complicated retinal detachment

European Journal of Ophthalmology ◽

10.1177/11206721211019551 ◽

2021 ◽

pp. 112067212110195

Author(s):

Orit Vidne-Hay ◽

Eva Platner ◽

Amir Alhalel ◽

Joseph Moisseiev

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Silicone Oil ◽

Final Visual Acuity ◽

Complication Rates ◽

Ocular Surgery ◽

Group A ◽

Silicone Oil Tamponade ◽

Group B

Purpose: To report the visual and anatomic outcomes of eyes with exceedingly long-term silicone oil tamponade. Methods: A retrospective chart review of 43 eyes of 41 patients with silicone oil tamponade for 5 years or more. Rates of retinal reattachment, visual acuity, and complications are presented. Further analysis was performed to identify if silicone oil complications are more common in eyes with lower vision. For this, cases were divided into group A-visual acuity of 20/400 or better and group B-visual acuity of less than 20/400. Results: Mean silicone oil duration was 12.6 ± 6.3 years. The etiology at presentation included: recurrent RRD (60.46%), RRD secondary to trauma (25.58%), and TRD (13.95%). Ninety-three percent of eyes underwent at least one ocular surgery before the vitrectomy with silicone oil tamponade. The retinal attachment rate was 55.8%. Mean visual acuity at presentation was 2.03 ± 0.6 logMAR, and at the final follow-up, 1.85 ± 0.78 logMAR ( p = 0.166). Emulsification developed in 33.3% of cases, glaucoma in 28.6%, band keratopathy in 21.4%, and corneal decompensation in 16.7%. In 26.2% of eyes, the final visual acuity was 20/400 or better (group A). In 73.8% of eyes, final visual acuity was worse than 20/400 (group B). The rates of silicone oil emulsification and glaucoma were not statistically significant between groups. Conclusions: Long-term silicone oil tamponade is a possible option in eyes with complicated retinal detachment following multiple intravitreal procedures, although the complication rates are relatively high. In 26.2% of eyes, visual acuity of 20/400 or better can be preserved for many years.

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Treatment of the сomplications of long-term silicone oil tamponade in a patient with retinopathy of prematurity and recurrent retinal detachment

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-367-374 ◽

2021 ◽

pp. 367-374

Author(s):

A. Kolesnik ◽

◽

B. Malyugin ◽

E. Pedanova ◽

I. Gorshkov ◽

...

Keyword(s):

Anterior Chamber ◽

Retinopathy Of Prematurity ◽

Silicone Oil ◽

Combined Treatment ◽

Corneal Thickness ◽

Functional Results ◽

Vitreous Cavity ◽

Silicone Oil Tamponade ◽

The Right

Objective. To present the clinical and functional results of combined treatment of the complications of long-term silicone oil tamponade in a patient with retinopathy of premature. Materials and methods. A 24-year-old patient diagnosed with stage 4b retinopathy of premature in a single seeing right eye. Between 2011 and 2020 underwent 5 microinvasive revisions of the vitreous cavity with replacement of silicone oil and median duration of silicone oil tamponade of 19+25.5 months over this entire period. Because of the constant migration of emulsified silicone oil to anterior chamber due to weakness of iridolenticular ligaments, band keratopathy developed in the right eye, opacity of the IOL due to the adhesion of precipitates on its anterior and posterior surfaces, pupillary membrane, and aggravation of the proliferative membrane on the ocular surface. UCVA was proectio incerta and IOP was 17 mmHg. The median thickness of the cornea was 853 μm, the average thickness of the corneal calcifications is 57 μm. The patient underwent revision of the vitreous cavity with removal of the pupillary membrane, the next steps were to install bandage sutures in the anterior chamber parallel to iris in two mutually perpendicular surfaces to create additional barriers to silicone oil migration. Then we used 27 mg of K3-EDTA to produce 0.1% chelating solution and to remove corneal calcium deposits. Final stage was YAG – laser discision of precipitates from the IOL surfaces. Results. Postoperatively UCVA of the right eye in 1-month was 0.05, IOP was 17 mmHg and endothelial cell density was 1200 cells / mm2. According to OCT data the median corneal thickness was 640 μm, the thickness of the epithelial layer was 39 μm. Biomicroscopically, cornea was transparent, a single silicone oil vesicle in the lower segment of anterior chamver, the bandage sutures are consistent, the IOL is centered with a transparent optical zone, silicone oil visualized on the fundus, epi- and subretinal proliferates were delimited by laser coagulates, epiretinal membrane was in the macular region. Key words: retinopathy of prematurity, silicone oil, emulsification, ribbon-like keratopathy, bandage threads, EDTA.

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Experience in surgical treatment of idiopathic macular ruptures in Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-2-97-100 ◽

2021 ◽

pp. 97-100

Author(s):

A.S. Firsov ◽

◽

A.D. Chuprov ◽

V.A. Trubnikov ◽

A.E. Voronina ◽

...

Keyword(s):

Surgical Treatment ◽

Silicone Oil ◽

Platelet Rich Plasma ◽

Functional Results ◽

State Institution ◽

Federal State ◽

Rate Of Increase ◽

Surgical Methods ◽

Medical Effectiveness ◽

Group 5

Purpose. To study the anatomical and functional results of various methods of surgical treatment of idiopathic macular rupture. Material and methods. In the course of this study, 50 medical records of patients with a diagnosis of macular rupture were randomly selected from the total number of those, who underwent the surgery at the Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution for 2020 year. Patients were divided into 3 groups. In the first group (38 eyes), the macular rupture was closed using ACP and PRP, in the second group (7 eyes) – using an inverted flap of the internal border membrane, in the third group (5 eyes) – by mechanical convergence of the edges of the rupture followed by tamponade of the vitreous cavity with silicone oil. Results. To assess the medical efficiency of the studied methods of surgical treatment of idiopathic macular rupture, the rate of increase in the maximum corrected visual acuity (MCVA) was calculated for each patient. Conclusion. The calculated indicator of the dynamics of vision improvement «the rate of BCVA growth» as a whole reflects the positive dynamics of the treatment of idiopathic macular rupture by surgical methods and can be used to assess the medical effectiveness of methods of treating patients with eye diseases initially with different values of the BCVA parameter. In the course of the analysis, no significant differences were found between the influence of various methods of surgical treatment of macular rupture on the rate of BCVA growth or rupture closure. Correlation analysis did not establish a statistically significant dependence of the growth rate of BCVA on the initial size of the rupture. Key words: macular rupture, inverted flap, platelet-rich plasma (PRP), autologous conditioned plasma (ACP).

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Long-term outcomes of free internal limiting membrane transplant for unclosed macular holes after extensive internal limiting membrane peeling and silicone oil tamponade: a report of two cases

Hong Kong Journal of Ophthalmology ◽

10.12809/hkjo-v24n1-267 ◽

2020 ◽

Vol 24 (1) ◽

pp. 18-21

Author(s):

Alvin KH Kwok

Keyword(s):

Silicone Oil ◽

Internal Limiting Membrane ◽

Long Term Outcomes ◽

Internal Limiting Membrane Peeling ◽

Membrane Peeling ◽

Macular Holes ◽

Silicone Oil Tamponade

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The Management of Giant Retinal Tears with Silicone Oil

European Journal of Ophthalmology ◽

10.1177/112067210301300211 ◽

2003 ◽

Vol 13 (2) ◽

pp. 192-195 ◽

Cited By ~ 8

Author(s):

N. Ünlü ◽

H. Kocaoğlan ◽

M.A. Acar ◽

M. Sargin ◽

B.S. Aslan ◽

...

Keyword(s):

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Functional Results ◽

Ocular Surgery ◽

Giant Retinal Tear ◽

Perfluorocarbon Liquids ◽

Retinal Tears ◽

History Of ◽

Pars Plana ◽

Silicone Oil Tamponade

Purpose To report the surgical success of vitrectomy with silicone oil tamponade in the treatment of retinal detachment associated with giant retinal tears due to various factors. Methods We retrospectively evaluated 21 eyes of 21 patients with retinal tears 90° or greater that underwent vitrectomy, with injection of perfluorocarbon liquids and silicone oil tamponade. Eight eyes (38.1%) had previous ocular surgery (4 aphakia-pseudophakia, 4 pars plana vitrectomy), 4 eyes (19.0%) had a history of trauma (blunt injuries in 2 and penetrating injury in 2), 3 (14.3%) had high myopia. Six eyes (28.6%) had no known condition predisposing to development of giant retinal tear. Results Retinal attachment was obtained in 17 (80.5%) of 21 eyes, with a mean follow-up of 12.5 months. Visual acuity improved in 15 eyes (71.4%). Conclusions Pars plana vitrectomy with silicone oil tamponade proved highly effective in giant retinal tears in terms of anatomical and functional results.

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