Direct Transretinal Removal of Subfoveal Perfluorocarbon Liquid: The Role and Timing of Internal Limiting Membrane Peeling

2017 ◽  
Vol 27 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Stefano De Cillà ◽  
Micol Alkabes ◽  
Paolo Radice ◽  
Elisa Carini ◽  
Carlos Mateo
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Internal Limiting Membrane ◽  
Perfluorocarbon Liquid ◽  
Ilm Peeling ◽  
The Status ◽  
Anatomic Results ◽  
Silicone Oil Tamponade

Purpose To describe a case series including 4 patients undergoing direct transretinal aspiration of subfoveal perfluorocarbon liquid (PFCL) and internal limiting membrane (ILM) peeling after macula-off retinal detachment surgery. Methods Four patients who had undergone vitreoretinal surgery due to primary rhegmatogenous retinal detachment were further treated because of retained subfoveal PFCL. Direct transretinal aspiration of PFCL through a self-sealing foveal retinotomy was performed in all cases using a 41-G needle placed on the top of the bubble. The ILM was peeled off prior to and after PFCL removal in 2 cases, respectively. Optical coherence tomography (OCT) scans were obtained preoperatively and postoperatively to assess the status of the macula. Results Subfoveal PFCL was successfully removed in all cases. Two patients had silicone oil tamponade at the time of the second surgery, which was temporarily removed in both cases and then reapplied in one. Best-corrected visual acuity improved in all cases. No postoperative macular hole was observed by OCT. Conclusions Direct transretinal aspiration of subfoveal PFCL with a 41-G cannula combined with conventional ILM peeling is a safe and effective technique to avoid long-term damage to the retinal layers with good functional outcomes. Performing the ILM peeling immediately before or after the PFCL aspiration does not seem to influence anatomic results.

scholarly journals Internal Limiting Membrane Peeling for Persistent Submacular Fluid after Successful Repair of Diabetic Tractional Retinal Detachment

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Byung Ju Jung ◽  
Sohee Jeon ◽  
Kook Lee ◽  
Jiwon Baek ◽  
Won Ki Lee
Keyword(s):  
Retinal Detachment ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Effective Treatment Option ◽  
Retrospective Case ◽  
Tractional Retinal Detachment ◽  
Vascular Arcade ◽  
Pars Plana ◽  
Successful Repair

This study is for reporting the outcomes of internal limiting membrane (ILM) peeling on persistent submacular fluid (PSF) after otherwise successful pars plana vitrectomy (PPV) for diabetic tractional retinal detachment (TRD). In this retrospective case series, five consecutive patients (5 eyes) who exhibited PSF following successful repair of diabetic TRD were included. The second operation was performed to remove ILM. The area of ILM peeling was expanded up to the major vascular arcade. Only air tamponade was used. The median interval between the first PPV and the second PPV with ILM peeling was 4.8 months (range: 4–6 months). PSF resolved completely within one (2 eyes) or 2 months after ILM peeling. The median logMAR best-corrected visual acuity (BCVA) was improved from 1.00 (Snellen equivalent 20/200) to 0.70 (Snellen equivalent 20/100). In conclusion, wide ILM peeling is an effective treatment option for PSF subsequent to successful repair of diabetic TRD. ILM peeling might increase the elasticity of retina, thereby allowing the retina to flatten. This procedure can induce faster retinal reattachment in diabetic TRD involving the macula.

Macular Changes on Optical Coherence Tomography Before, During, and After Silicone Oil Tamponade for Macula-On Retinal Detachment: A Case Series

2018 ◽  
Vol 2 (5) ◽  
pp. 297-301 ◽  
Author(s):  
Wajiha J. Kheir ◽  
Carl-Joe Mehanna ◽  
Mona Koaik ◽  
Ziad Bashshur
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Ganglion Cell Layer ◽  
Silicone Oil ◽  
Case Series ◽  
Qualitative Assessment ◽  
Optical Coherence ◽  
Time Points ◽  
Silicone Oil Tamponade

Purpose: Assess changes on spectral domain optical coherence tomography (OCT) before, during, and after removal of silicone oil (SO). Methods: Retrospective series of patients who underwent SO tamponade for macula-on rhegmatogenous retinal detachment. OCT scans of the affected eye were taken before, during, and 3 months after SO tamponade. Qualitative assessment of foveal contour and quantitative comparison of OCT parameters (central macular, cube, ganglion cell layer [GCL], and outer retinal thicknesses) were done between 3 time points. Results: Ten eyes of 9 patients were included. Flattening of the foveal contour during SO tamponade was completely reversed after SO removal. Average cube and GCL thicknesses decreased with SO tamponade and increased after SO removal ( P = .01 and P = .02, respectively). Outer retinal thicknesses did not vary among 3 time points ( P = .09). Conclusions: SO tamponade causes foveal flattening and thinning of the inner retinal layers, which is reversible on removal.

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.

Removal of Sticky Silicone Oil Adhered to the Retinal Surface: Comparison of Methodological Safety and Effectiveness

2021 ◽  
Author(s):  
Ziqi Wang ◽  
Zongduan Zhang ◽  
Xuting Hu ◽  
Zhaoliang Zhang ◽  
Qintuo Pan
Keyword(s):  
Silicone Oil ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Ilm Peeling ◽  
Retinal Surface ◽  
Disc Diameter ◽  
Minimum Angle ◽  
Oil Residue ◽  
The Mean ◽  
23 Gauge

Abstract Purpose: To compare safety and effectiveness among methods to remove sticky silicone oil bubbles adhered to the retinal surface. Methods: This retrospective nonrandomised case series included 14 eyes of 14 patients who had sticky silicone oil residue during silicone oil removal surgery. For small sticky silicone oil bubbles (<2-disc diameter), aspiration was performed with a 23-gauge vitreous cutter. Residual tiny oil bubbles were then removed with a silicone-tipped flute needle or internal limiting membrane (ILM) peeling. For large sticky silicone oil bubbles (≥2-disc diameter) that could not be removed with a 23-gauge vitreous cutter, we devised a more efficient active removal method involving a modified 22-gauge venous indwelling cannula device. Results: The mean preoperative best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR]) significantly improved from 1.28±0.63 logMAR to 0.77±0.58 logMAR (p=0.014). The postoperative BCVA and improvement in BCVA were significantly better in the ILM peeling group than in the non-ILM peeling group (p=0.004 and p=0.045, respectively). Postoperative complications included residual sticky silicone oil bubbles in seven eyes without ILM peeling (50.0%), retinal neuroepithelial layer damage in two eyes (14.3%), and temporary hypotony in five eyes (35.7%). Conclusion: Various methods can safely and efficiently remove sticky silicone oil bubbles adhered to the retinal surface. A 22-gauge venous indwelling cannula enabled simple and safe removal of large sticky silicone oil bubbles, while small residual sticky silicone oil bubbles could be completely removed by ILM peeling.

VITREORETINAL SURGERY WITH SILICONE OIL TAMPONADE IN PRIMARY UNCOMPLICATED RHEGMATOGENOUS RETINAL DETACHMENT

Retina ◽  
2016 ◽  
Vol 36 (10) ◽  
pp. 1906-1912 ◽  
Author(s):  
Joelle Antoun ◽  
Georges Azar ◽  
Elyse Jabbour ◽  
Hampig Raphael Kourie ◽  
Elise Slim ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Silicone Oil Tamponade

scholarly journals Surgery for Combined Hamartoma of the Retina and Retinal Pigment Epithelium

2021 ◽  
pp. 778-783
Author(s):  
Charlotte Maria van der Sommen ◽  
Saskia Helena Margaretha van Romunde ◽  
Koen-Willem Adriaan van Overdam
Keyword(s):  
Visual Acuity ◽  
Retinal Pigment Epithelium ◽  
Silicone Oil ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Vitreoretinal Surgery ◽  
Internal Limiting Membrane ◽  
Epiretinal Membranes ◽  
Vitreous Cortex ◽  
Silicone Oil Tamponade

There is no consensus on whether and when surgical treatment is indicated for combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). We aim to discuss the benefits of surgical intervention and techniques that may improve the outcome. A 24-year-old man experienced progressive visual loss for 6 months in his left eye due to CHRRPE. At presentation, visual acuity was 1.3 LogMAR and fundoscopy revealed extensive tractional pre- and epiretinal membranes, subretinal exudation, and a vasoproliferative tumor in the inferior periphery. A complete vitrectomy was performed, while paying special attention to vitreous shaving at the vitreous base and removal of vitreoschisis-induced vitreous cortex remnants (VCR) from the retinal surface posterior to the vitreous base. Tractional membranes and internal limiting membrane were peeled, and the vasoproliferative tumor was excised. Silicone oil tamponade was removed 11 weeks after surgery. No intra- or postoperative complications occurred. Visual acuity improved to 0.8 LogMAR and remained stable for 48-month follow-up. Vitreoretinal surgery can prevent complications that occur with CHRRPE. In addition, visual function may improve even if the initial visual acuity is low. Timely and complete vitrectomy with extensive membranectomy and detection and removal of VCR is recommended to avoid complications in challenging CHRRPE.

scholarly journals Pars Plana Vitrectomy with Internal Limiting Membrane Peeling in Traumatic Macular Hole: 14% Perfluoropropane (C3F8) versus Silicone Oil Tamponade

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ashraf Bor’i ◽  
Mahmoud A. Al-Aswad ◽  
Ahmed Abdelwahab Saad ◽  
Dina Hamada ◽  
Ashraf Mahrous
Keyword(s):  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Internal Limiting Membrane ◽  
Spontaneous Closure ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
The Mean ◽  
Retrospective Comparative Study

Purpose. To evaluate the outcome of 23 G PPV and ILM peeling with 14% C3F8 compared with silicone oil tamponade in cases of TMHs without spontaneous closure. Methods. A retrospective comparative study included 33 eyes with TMHs; 7 eyes healed spontaneously, and the remaining 26 eyes have been treated with PPV and ILM peeling. Silicone oil was used as a tamponade for children or adults who refused to adopt face-down position (10 cases). In all other cases (16 cases), 14% C3F8 was used. These cases were followed up for 6 months postoperatively. Results. 26 cases (22 males and 4 females) were reviewed, including 10 cases treated with silicone oil and 16 cases treated with 14% C3F8. Patients’ age ranged from 9 to 54 years. The success rate was 90% in the silicone-filled (9/10) and 94% in the gas-filled (15/16) eyes. At 6 months, the mean BCVA was 0.3 ± 0.25 in the silicone group and 0.2 ± 0.13 in the gas group (p<0.05). Conclusions. Cases of TMHs should be observed for spontaneous closure. PPV with ILM peeling should be conducted for nonclosing cases. Gas and silicone oil tamponades are equally successful in anatomical and visual outcomes. This trial is registered with CTRI/2017/06/008765.

scholarly journals Case Series of Inappropriate Concentration of Intraocular Sulfur Hexafluoride

2018 ◽  
Vol 9 (2) ◽  
pp. 405-410 ◽  
Author(s):  
Piotr Kanclerz ◽  
Andrzej Grzybowski
Keyword(s):  
Sulfur Hexafluoride ◽  
Silicone Oil ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Calculation Error ◽  
Gas Concentration ◽  
Care Training ◽  
Silicone Oil Tamponade ◽  
Intravitreal Gas ◽  
Patient Safety Incidents

Due to high complexity, vitreoretinal surgery presents a higher number of patient safety incidents compared with other ophthalmic procedures. Intraocular gases are one of the most useful adjuncts to vitrectomy and surprisingly, surgeons commonly admit to having occasional problems with incorrect gas concentration. The aim of this study is to present a consecutive case series of patients with improper concentration of sulfur hexafluoride (SF6) applied during vitrectomy. Three patients underwent 27-gauge vitrectomy and at the end of surgery inappropriate dilution of 100% SF6 was administered. It was attributed to a calculation error, change in the gas supplier, or increased partial pressure of SF6 before dilution. Postoperatively, due to IOP increase, two eyes required intravitreal gas-air exchange. Subsequently, cataract surgery was performed in one eye with concomitant vitrectomy and silicone oil tamponade due to retinal detachment. To prevent such complications, we suggest using intraocular gases with great care, training of ophthalmic personnel, and prompting manufacturers to provide SF6 in a prepared concentration of 20%.

Modified Superior Inverted Internal Limiting Membrane Flap Technique With Vitrectomy Versus Vitrectomy With Internal Limiting Membrane Peeling For Retinal Detachment With Myopic Macular Hole

2021 ◽  
Author(s):  
María José Crespo Carballés ◽  
Marina Sastre-Ibáñez ◽  
Mar Prieto del Cura ◽  
Laura Jimeno Anaya ◽  
Natalia Pastora Salvador ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Retinal Layer ◽  
Ilm Peeling ◽  
Closure Rate ◽  
Flap Technique ◽  
Before And After ◽  
Hole Closure

Abstract Purpose: To evaluate the efficacy of the modified superior inverted internal limiting (ILM) membrane flap technique in retinal reattachment, macular hole closure and external retinal layers restoration in macular hole associated retinal detachment compared to ILM peeling. Methods: Retrospective case series of 10 patients that required pars plana vitrectomy for retinal detachment with macular hole followed for more than 12 months. Data from medical records were retrospectively collected and patients were divided into the superior inverted flap (5 patients) and ILM peeling group (5 patients). We compared best corrected visual acuity (BCVA) before and after surgery, retinal attachment, macular hole closure rate and external retinal layer restoration between groups. Results: There were significant improvements in BCVA in both groups before and after surgery, with no differences between the two groups at 12 months after surgery (p = 0.9). The macular hole closed in 100% of cases in the inverted flap group and 80% of the ILM peeling group with no significant differences between groups. The retina was reattached in 100% of cases in both groups. Only 2 patients in the inverted flap group (40%) had external retinal layer restoration and none in ILM peeling group (p=0,62). Conclusions: ILM peeling and superior inverted flap techniques are useful for treating retinal detachment with macular hole in myopic eyes.

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