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Al-Shehri AM, Aljohani S, Aldihan KA, Alrashedi MJ, Alrasheed S, Schatz P. Effect of silicone oil versus gas tamponade on macular layer microstructure after pars plana vitrectomy for macula on rhegmatogenous retinal detachment. BMC Ophthalmol 2024; 24:119. [PMID: 38486220 PMCID: PMC10938769 DOI: 10.1186/s12886-024-03377-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
PURPOSE To analyze structural changes in the macular retinal layers and sub-foveal choroidal thickness (SFCT) in eyes after macula-on rhegmatogenous retinal detachment (RRD) repair by pars plana vitrectomy with either silicone oil (SO) or gas tamponade, and the effect of these changes on visual acuity. PATIENTS AND METHODS Retrospective study which included 26 eyes in the SO Group and 32 in the Gas Group. Optical coherence tomography (OCT) scans of the affected eyes were obtained before surgery, and 3 months after PPV in the Gas Group, and during silicone oil in situ and 3 months after SO removal, in the SO Group. Qualitative assessment of photoreceptor layer and foveal contour, along with quantitative assessment of macular retinal thickness and SFCT was performed. Postoperative OCT macular microstructural changes were recorded and correlated to corrected distance visual acuity (CDVA). Intraocular pressure (IOP) was measured preoperative and at 3 months post operative. RESULTS There was a 2-line loss (from 20/28 preoperatively to 20/40 at final follow-up) of CDVA in the SO Group (p=0.051), while there was no statistically significant change in CDVA in the Gas Group (p=0.786). There was no significant correlation between CDVA loss and duration of silicon tamponade (r=-0.031, p=0.893). There was a statistically significant increase in IOP from its baseline to final follow-up of 0.7 mmHg in the SO Group (p=0.023) while there was no statistically significant change in IOP in the Gas Group. During silicone oil tamponade, there was approximately 11% and 5% of retinal and sub-foveal choroidal thinning respectively, which was moderately resolved following silicone oil removal. 20% (5/24) of eyes in the SO Group had qualitative flattening of foveal contour during SO tamponade that resolved after SO removal. CONCLUSION Thinning of the macula was noticed after macula-on RRD repair with SO tamponade. Such thinning was only partially reversible after the removal of SO.
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Affiliation(s)
- Abdulaziz Mohammed Al-Shehri
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
- Surgery Department, Taif university, Taif, Saudi Arabia.
| | - Saud Aljohani
- Ophthalmology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalid Abdulaziz Aldihan
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Musa Johaiman Alrashedi
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Saad Alrasheed
- Diagnosic imaging department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Patrik Schatz
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Ophthalmology, Clinical Sciences, Skane University Hospital, Lund University, Lund, Sweden
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Chen J, Guan L, Liu Y, Song Y, Tang Y, Cao Y, Li M, Sheng A, Zhang Z, Liu H. Choroidal vascular changes in silicone oil-filled eyes after vitrectomy for rhegmatogenous retinal detachments. BMC Ophthalmol 2023; 23:442. [PMID: 37919665 PMCID: PMC10621110 DOI: 10.1186/s12886-023-03167-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION The tamponade of silicone oil (SO) can affect both the structure and blood flow of the retina. However, there are few studies on the effect of SO tamponade on choroidal blood flow. Our study aimed to compare the effects of SO tamponade on the choroidal vascular index (CVI) and choroidal thickness (CT) in patients with unilateral rhegmatogenous retinal detachment (RRD) with operated eyes and fellow healthy eyes. METHODS We retrospectively collected demographic and clinical data from 36 patients who underwent 23G pars plana vitrectomy and SO tamponade for unilateral complicated RRD. Enhanced depth imaging-optical coherence tomography (EDI-OCT) scans were performed both within 1 week before SO removal and at the last follow-up visit after SO removal. Using ImageJ software, images were binarized to segment the total choroidal area, luminal area, and stromal area, respectively. The CVI was calculated as CVI=(luminal area)/(total choroidal area), and CT was also evaluated. RESULTS During SO tamponade, the CVI and luminal area in operated eyes were significantly lower compared to fellow eyes (57.616 ± 0.030 vs. 60.042 ± 0.019, P < 0.0001; 0.909 [0.694; 1.185] vs. 1.091 [0.785; 1.296], P = 0.007). Even after SO removal, the CVI remained lower in operated eyes than in fellow eyes (59.530 ± 0.018 vs. 60.319 ± 0.020, P = 0.031). Both CVI and luminal area were lower in operated eyes before SO removal than after SO removal (57.616 ± 0.030 vs. 59.530 ± 0.018, P = 0.0003; 0.909 [0.694; 1.185] vs. 0.994 [0.712; 1.348], P = 0.028). The duration of SO tamponade was positively correlated with the difference in CVI between fellow eyes and operated eyes during SO tamponade (P = 0.035). Total choroidal area, stromal area, and CT did not differ significantly between fellow eyes and operated eyes or between pre- and post-SO removal. CONCLUSIONS SO tamponade reduces CVI and decreases choroidal blood circulation in patients with retinal detachments required vitrectomy combined with SO tamponade. The longer the SO tamponade time, the more CVI reduction. In future work, we will aim to reduce these side effects by shortening the duration of silicone oil filling.
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Affiliation(s)
- Jiayu Chen
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Lina Guan
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China
| | - Yalu Liu
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China
| | - Yingying Song
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Yu Tang
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Yumei Cao
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Meishuang Li
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
| | - Aiqin Sheng
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China
| | - Zhengpei Zhang
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China.
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China.
| | - Haiyang Liu
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Department of Ophthalmology, Xuzhou First People's Hospital, 269 Daxue Road, Tongshan District, Xuzhou, 221000, China.
- Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, 221004, China.
- Eye Disease Prevention and Treatment Institute of Xuzhou, 269 Daxue Road, Tongshan District, Xuzhou, 2210004, China.
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Felfeli T, Murtaza F, Herman J, Pereira AM, Mandelcorn MS, Mandelcorn ED. Anatomical and functional outcomes of short-term DensironXTRA heavy silicone oil for rhegmatogenous retinal detachments: a comparative case series. Sci Rep 2023; 13:3729. [PMID: 36878935 PMCID: PMC9988839 DOI: 10.1038/s41598-023-30210-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
To assess the safety and efficacy of short-term DensironXTRA tamponade for repair of complicated rhegmatogenous retinal detachments (RRD). This is a retrospective consecutive case series of patients undergoing pars plana vitrectomy (PPV) with intravitreal DensironXTRA and a comparator group with gas (sulfur hexafluoride (SF6) or perfluoropropane (C3F8)) tamponades by a single surgeon between January 2017 and November 2020 at a tertiary care centre. A total of 121 eyes with DensironXTRA and 81 comparator eyes with a gas tamponade were included. The DensironXTRA group had a significantly higher number of cases with inferior breaks (82% vs. 48%; p < 0.0001) and a history of previous PPV for RRD (64% vs. 12%; p < 0.0001). DensironXTRA was removed after a median period of 70 (IQR: 48.5-105.5) days. There was similar anatomical success in both the comparator gas tamponade and DensironXTRA groups (98.8% vs. 97.5%, p = 0.6506). Although both groups experienced a significant improvement in visual acuity, this change was significantly higher in the comparator gas tamponade group versus DensironXTRA group (p = 0.0017). There was no significant change in IOP in the DensironXTRA group (mean difference - 0.7; 95% CI - 1.753 to 0.331, p = 0.1785). The rates of complications were low and not significantly different between the two groups. There was no evidence for central macular thinning with DensironXTRA compared to the contralateral eye without RRD as well as with DensironXTRA in situ versus after its removal. DensironXTRA is a promising short-term tamponade agent with good anatomical and functional outcomes and low rates of complications for the repair of complicated RRDs.
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Affiliation(s)
- Tina Felfeli
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada. .,Management and Evaluation (IHPME), Dalla Lana School of Public Health, The Institute of Health Policy, University of Toronto, Toronto, ON, Canada. .,Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital, Eaton Building, 10th Floor, Toronto, ON, M5G 2C4, Canada.
| | - Fahmeeda Murtaza
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Joshua Herman
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Austin M Pereira
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Mark S Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.,Department of Ophthalmology, Toronto Western Hospital, University Health Network, 6E-432, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada
| | - Efrem D Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada. .,Department of Ophthalmology, Toronto Western Hospital, University Health Network, 6E-432, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.
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Ghanbari H, Kianersi F, Jamshidi Madad A, Dehghani A, Rahimi A, Feizi A, Naderi Beni A. The effect of silicone oil tamponade on retinal layers and choroidal thickness in patients with rhegmatogenous retinal detachment: a systematic review and meta-analysis. Int J Retina Vitreous 2021; 7:76. [PMID: 34930505 PMCID: PMC8691011 DOI: 10.1186/s40942-021-00348-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/25/2021] [Indexed: 01/10/2023] Open
Abstract
Background To evaluate the effects of intravitreal silicone oil (SO) on the retinal and choroidal thickness in eyes with rhegmatogenous retinal detachment (RRD). Methods A literature search was performed in Web of Science, Scopus, ProQuest, Embase, Clinical Key, Science Direct, Cochrane Library, and Springer, as well as Persian databases, including IranDoc, MagIran, SID, MOH thesis, and MOH articles until June 2020. Two reviewers independently searched and extracted the data. Results Sixteen studies (n = 391) met the inclusion criteria. The meta-analysis showed that the SO tamponade could significantly reduce the central macular thickness (CMT) in patients with RRD as compared to gas tamponade WMD = − 14.91; 95% CI: − 22.23, − 7.60; P < 0.001, I2 = 71%). No significant change was found in CMT between the eye with SO tamponade (after SO removal) and the fellow healthy eye in patients with RRD (WMD = − 3.52; 95% CI: − 17.63, 10.59; I2 = 68.6%). Compared to the preoperative stage, the SO tamponade could significantly reduce the subfoveal choroidal thickness in patients with RRD (WMD = − 18.67, 95% CI: − 30.07, − 1.28; I2 = 80.1%). However, there was no significant difference in the subfoveal choroidal thickness before and after SO removal (WMD = − 1.13, 95% CI: − 5.97, 3.71; I2 = 87.6%). Conclusion The SO tamponade had a significant effect on the reduction of retinal layers and the subfoveal choroidal thickness.
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Affiliation(s)
| | - Farzan Kianersi
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Alireza Dehghani
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Rahimi
- Clinical Informationist Resarch Group, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Afsaneh Naderi Beni
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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