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Simpson AI, Hind J, Lockington D. Correspondence on: a model for anterior vitrectomy in real patients: simulation for practical training. Eye (Lond) 2024:10.1038/s41433-024-03296-7. [PMID: 39187655 DOI: 10.1038/s41433-024-03296-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/19/2024] [Accepted: 08/07/2024] [Indexed: 08/28/2024] Open
Affiliation(s)
- Alasdair I Simpson
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK.
| | - Jennifer Hind
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
| | - David Lockington
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
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Sborgia L, Albano V, Sborgia A, Viggiano P, Boscia G, Zerbinati M, Pozharitskiy N, Binetti R, Dimiccoli R, Fracchiolla A, Boscia F, Alessio G. FUNCTIONAL AND ANATOMICAL OUTCOMES AFTER SHORT-TERM HEAVY SILICONE OIL ENDOTAMPONADE FOR INFERIOR RHEGMATOGENOUS RETINAL REDETACHMENT: A Pilot Study. Retina 2024; 44:1142-1149. [PMID: 38452264 DOI: 10.1097/iae.0000000000004092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
PURPOSE To assess the success of the short-term location of the heavy silicone oil (Densiron 68, HSO) as endotamponade after pars plana vitrectomy for rhegmatogenous complex retinal redetachment. METHODS Consecutive, retrospective, nonrandomized, pilot study was conducted. Twenty-two eyes of 22 patients with complex inferior retinal redetachment previously tamponade with gas (SF6 or C3F8) or 1000 cSt standard silicone oil (SSO) were selected. All were treated with HSO endotamponade, and its removal was performed after 1 month. The main outcomes were best-corrected visual acuity and postoperative complications after the HSO removal. RESULTS Of the 22 eyes, 10 were treated with SSO endotamponade, 3 with fluorinated gas 14% C3F8, and 9 with 20% SF6 at first surgery. In all eyes, a complex inferior retinal redetachment was observed after the first surgery, in 1 month to 3 months after silicone oil removal or gas endotamponade introduction. In 10 eyes, the proliferative vitreoretinopathy (Grade B or C 1-3) was found. The main best-corrected visual acuity before HSO removal was 0.55 ± 0.20 the logarithm of the minimum angle of resolution (range 0.4-0.7) and after the HSO removal, it was 0.32 ± 0.29 the logarithm of the minimum angle of resolution (0.1-0.4). Among the postoperative complications, only in four eyes the macular edema was found (medically resolved), in four eyes an increase of intraocular pressure, and none of these developed the epiretinal membrane. CONCLUSION The main purpose of this study is to establish a short-term HSO endotamponade in eyes with complex retinal detachment recurrences, reducing the possible postoperative complications and having a better prognosis for visual acuity outcomes.
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Affiliation(s)
- Luigi Sborgia
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Valeria Albano
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University Hospital Polyclinic of Bari, Bari, Italy; and
| | - Alessandra Sborgia
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Pasquale Viggiano
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Giacomo Boscia
- Ophthalmology Unit, A.O.U. City of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Marta Zerbinati
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Nikolai Pozharitskiy
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Roberta Binetti
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Roberta Dimiccoli
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Antonio Fracchiolla
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Francesco Boscia
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
| | - Giovanni Alessio
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Eye Clinic, University of Bari, Bari, Italy
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Nishath T, Anderson KL, Batchelor TJ. Young Woman With Recurrent Vision Loss. Ann Emerg Med 2024; 83:611-612. [PMID: 38777499 DOI: 10.1016/j.annemergmed.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 05/25/2024]
Affiliation(s)
- Thamanna Nishath
- Department of Emergency Medicine, Stanford University, Palo Alto, CA
| | - Kenton L Anderson
- Department of Emergency Medicine, Stanford University, Palo Alto, CA
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Qu S, Zhou Q, Shao YT, Lin MY, Shen JQ, Niu GZ, Han WT, Zhang L, Bi YL. Posterior capsular radial sign: a novel method to confirm anterior vitreous cortex resection in phacovitrectomy. BMC Ophthalmol 2024; 24:231. [PMID: 38822280 PMCID: PMC11143691 DOI: 10.1186/s12886-024-03474-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: 09/09/2023] [Accepted: 05/02/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The main purpose of this paper is to introduce a method that can accurately locate the posterior capsule of the lens to facilitate a relatively complete resection of the anterior vitreous body. METHODS A total of 51 patients in the experimental group and control group were enrolled in this study. Phacoemulsification combined with vitrectomy was performed in all cases. After the cataract procedure was completed in the control group, the surgeon performed a conventional anterior vitrectomy with the operative eye. In the experimental group, anterior vitrectomy was performed according to the threadiness corrugation of the posterior capsule of the lens. During the operation, with the help of triamcinolone, two surgeons confirmed the resection of the anterior vitreous cortex; the best corrected visual acuity and intraocular pressure of all patients were recorded at 1 week, 1 month and 3 months after surgery. RESULTS Fifty patients underwent phacoemulsification combined with vitrectomy, except one patient in the experimental group who was lost to follow-up. After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. There was no significant difference in preoperative visual acuity between the two groups (t = 0.83, P = 0.25). Both groups had varying degrees of improvement in best corrected visual acuity at 1 week, 1 month and 3 months after surgery. Moreover, there was no significant difference in BCVA between the two groups at the three follow-up time points (t=-1.15, -1.65, -1.09, P = 0.53, 0.21, 0.23). After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. Incomplete resection of the anterior vitreous cortex was observed in 2 patients in each group, but there was no significant difference (χ2 = 7.81, P > 0.05). CONCLUSION In the process of cataract surgery combined with vitrectomy, thready corrugation appears in the posterior capsule of the lens and is an important sign of its localization. Anterior vitrectomy can be accomplished safely and effectively with the help of thread-like corrugation, and the surgical effect is almost the same as that of traditional surgery. Especially suitable for beginners in vitreous surgery.
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Affiliation(s)
- Shen Qu
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Qi Zhou
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Yu-Ting Shao
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Ming-Yue Lin
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Jia-Qi Shen
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Guo-Zhen Niu
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Wen-Ting Han
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Li Zhang
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Yan-Long Bi
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.
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Valentín-Bravo FJ, Stanga PE, Reinstein UI, Stanga SEF, Martínez-Tapia SA, Pastor-Idoate S. Silicone oil emulsification: A literature review and role of widefield imaging and ultra-widefield imaging with navigated central and peripheral optical coherence tomography technology. Saudi J Ophthalmol 2024; 38:112-122. [PMID: 38988778 PMCID: PMC11232747 DOI: 10.4103/sjopt.sjopt_193_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 07/12/2024] Open
Abstract
Silicone oil (SO) emulsification is a significant concern in vitreoretinal surgery, leading to various complications. Despite the high prevalence of SO emulsification within the eye, there is currently no standardized method for its early detection. The recent introduction of widefield (WF) imaging and ultra-WF (UWF) imaging with navigated central and peripheral optical coherence tomography (OCT) techniques have shown promising results in providing high-resolution images of the peripheral vitreous, vitreoretinal interface, retina, and choroid. This enhanced visualization capability enables the early identification of emulsified SO droplets, facilitating a proactive therapeutic approach, and mitigating associated adverse events. This comprehensive literature review aims to provide an updated overview of the topic, focusing on the role of WFimaging and UWF imaging and navigated central and peripheral swept-source OCT (SS-OCT) in the early detection and management of SO emulsification. The review discusses the current understanding of SO emulsification, its associated complications, and the limitations of existing detection methods. In addition, it highlights the potential of WF and UWF imaging and peripheral OCT as advanced imaging modalities for improved visualization of SO emulsification. This review serves as a valuable resource for clinicians and researchers, providing insights into the latest advancements in the field of vitreoretinal surgery and the promising role of WF imaging and UWF imaging and navigated central and peripheral SS-OCT in the management of SO.
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Affiliation(s)
| | - Paulo E. Stanga
- The Retina Clinic London, London, UK
- Department of Ophthalmology, Institute of Ophthalmology, University College London, London, UK
| | | | | | | | - Salvador Pastor-Idoate
- Department of Ophthalmology, Clinical University Hospital, Valladolid, Spain
- Department of Ophthalmology, Ioba Eye Institute, University of Valladolid, Valladolid, Spain
- Networks of Cooperative Research Oriented to Health Results (RICORS), National Institute of Health Carlos III, ISCIII, Madrid, Spain
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Qu S, Tang Y, Ning Z, Zhou Y, Wu H. Desired properties of polymeric hydrogel vitreous substitute. Biomed Pharmacother 2024; 172:116154. [PMID: 38306844 DOI: 10.1016/j.biopha.2024.116154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 02/04/2024] Open
Abstract
Vitreous replacement is a commonly employed method for treating a range of ocular diseases, including posterior vitreous detachment, complex retinal detachment, diabetic retinopathy, macular hole, and ocular trauma. Various clinical substitutes for vitreous include air, expandable gas, silicone oil, heavy silicone oil, and balanced salt solution. However, these substitutes have drawbacks such as short retention time, cytotoxicity, high intraocular pressure, and the formation of cataracts, rendering them unsuitable for long-term treatment. Polymeric hydrogels possess the potential to serve as ideal vitreous substitutes due to their structure-mimicking to natural vitreous and adjustable mechanical properties. Replacement with hydrogels as the tamponade can help maintain the shape of the eyeball, apply pressure to the detached retina, and ensure the metabolic transport of substances without impairing vision. This literature review examines the required properties of artificial vitreous, including the optical properties, rheological properties, expansive force action, and physiological and biochemical functions of chemically and physically crosslinked hydrogels. The strategies for enhancing the biocompatibility and injectability of hydrogels are also summarized and discussed. From a clinical ophthalmology perspective, this paper presents the latest developments in vitreous replacement, providing clinicians with a comprehensive understanding of hydrogel clinical applications, which offers guidance for future design directions and methodologies for hydrogel development.
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Affiliation(s)
- Sheng Qu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China
| | - Yi Tang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China
| | - Zichao Ning
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China
| | - Yanjie Zhou
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China
| | - Hong Wu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China.
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Vidal-Oliver L, Mataix Boronat J, Palacios Pozo E, López-Prats MJ, Desco Esteban MC. Long-term complications according to silicone oil type. A single center cohort study. Eur J Ophthalmol 2024; 34:541-548. [PMID: 37671421 DOI: 10.1177/11206721231200034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
PURPOSE To study the incidence of macular edema (ME), ocular hypertension (OHT), emulsification and migration to the anterior chamber (AC) of silicone oil (SO) in patients after complex retina surgery, stratified by SO type. METHODS Retrospective, cohort study. Patients who underwent retina surgery with SO injection and extraction in our center were included. We compared the complication rates of ME, OHT, emulsification and migration to the AS according to SO type (1300cSt, 5700cSt and heavy SO). Data on age, sex, emulsification time, duration of the tamponade, previous retina surgeries and diagnosis were also gathered and included in a multivariate analysis. RESULTS We included 163 patients (mean age of 64.8 years; mean duration of the tamponade: 11 months). Rates of emulsification, ME, OHT and SO migration to the AC were similar in all groups (p = 0.998, 0.668, 0.915 and 0.360). ME was the most frequent complication (33.3-47.8%), which resolved after SO extraction in 77.6% of cases. The majority of cases with OHT persisted (61.7%). Emulsification was related to younger age (OR 0.94) and longer duration of the tamponade (OR 1.04). The odds of SO migration to the AC increased with emulsification (OR 2.78), recurrent retinal detachment (OR 0.99) and aphakia (OR 4.05). CONCLUSIONS We propose SO extraction as the preferred treatment for ME during SO tamponade. SO extraction should be performed sooner in younger patients to avoid emulsification. In selected patients, we suggest a longer duration of the tamponade up to 11 months with a reasonable safety profile, regardless of the SO type.
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Affiliation(s)
| | | | | | | | - M Carmen Desco Esteban
- Fundación Oftalmología Médica de la Comunidad Valenciana, Valencia, Spain
- Department of Medicine and Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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Riboni N, Ribezzi E, Marraffa E, Mora P, Bellucci C, Bianchi F, Careri M. An ex vivo headspace gas chromatography-mass spectrometry method for the determination of short-chain siloxanes in silicon oil tamponades used in ophthalmic surgery. J Pharm Biomed Anal 2024; 238:115871. [PMID: 38006704 DOI: 10.1016/j.jpba.2023.115871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
Being able to facilitate retinal reattachment by preventing water migration into the subretinal space, silicone oils are widely used as long-term intraocular tamponade to treat cases of retinal detachment. Various commercial tamponades constituted by linear polydimethylsiloxane polymers with different molecular weights and cyclic impurities are available. In this study, for the first time, an untargeted headspace-gas-chromatography-mass spectrometry (HS-GC-MS) method was developed to identify low-molecular weight contaminants in three different types of silicone oil tamponades, namely Siluron 2000, RS-OIL ECS5000 and Densiron Xtra. Both commercial and post-operative tamponades were analysed to screen for the different classes of compounds present in the samples. The most abundant classes were short-chain siloxanes, fluorinated compounds, and hydrocarbons. To quantify the siloxanes present in the samples, a targeted HS-GS-MS was optimized using a central composite design and validated according to guidelines for bioanalytical methods. Lower limits of quantification in the low μg/L range, good precision with RSD% < 12% and accuracy with recovery rates in the 81 ( ± 7) - 96 ( ± 4) % range were achieved. Short-chain siloxanes were quantified in both commercial and post-operative tamponades, being the RS-OIL ECS5000 characterized by the highest concentration levels of the investigated analytes. By contrast, Densiron Xtra tamponades showed the lowest amount of short-chain siloxanes, observing a general decrease in their concentration levels according to the residence time in the eyes.
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Affiliation(s)
- Nicolò Riboni
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy.
| | - Erika Ribezzi
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy
| | - Enrico Marraffa
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy
| | - Paolo Mora
- Ophthalmology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Carlo Bellucci
- Ophthalmology Unit, University Hospital of Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Federica Bianchi
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy.
| | - Maria Careri
- University of Parma, Department of Chemistry, Life Sciences and Environmental Sustainability, Parco Area delle Scienze, 17/A, 43124 Parma, Italy
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Donate J, Arias-Barquet L, Ruiz-Casas D, Larra-Mateos E, Pastor JC. Reporting serious incidents in medical devices used in intraocular surgery: Proposing ideas. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:723-726. [PMID: 37865190 DOI: 10.1016/j.oftale.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/23/2023]
Abstract
The entry into force of the regulation on medical devices obliges clinicians to identify and report to the Health Authorities possible serious incidents arising from their use. In view of the doubts that may arise as to whether or not it may be considered a serious incident, a working group, set up by members of the Spanish Society of Retina and Vitreo and the cluster of ophthalmology and vision sciences (Cluster4Eye) have prepared a document that aims to guide ophthalmologists about some of the incidents that, in the experience of the work team, are not common or can cause serious damage to the patient's function.
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Affiliation(s)
- J Donate
- Hospital La Luz, Quironsalud, Hospital Clínico San Carlos, Madrid, Spain
| | - L Arias-Barquet
- Hospital de Bellvitge, Universidad de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - D Ruiz-Casas
- Hospital Ramón y Cajal, Hospital HM Montepríncipe, Madrid, Spain
| | - E Larra-Mateos
- AJL Ophthalmic S.A., Vitoria, Spain; Cluster4Eye, Valladolid, Spain
| | - J C Pastor
- Cluster4Eye, Valladolid, Spain; IOBA, Universidad de Valladolid, Valladolid, Spain.
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Romano MR, Ferrara M, Coco-Martin RM, Rickmann A, Spitzer MS, Steel DHW, Pastor JC. INTRAOCULAR EMULSION OF SILICONE OIL (ITEMS) GRADING SYSTEM: An Evidence-Based Expert-Led Consensus. Retina 2023; 43:1370-1376. [PMID: 37071921 DOI: 10.1097/iae.0000000000003811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
PURPOSE To propose the InTraocular EMulsion of Silicone oil (ITEMS) grading system for the assessment of silicone oil (SiO) emulsion, applicable in a routine clinical setting and validated through an expert-led consensus procedure. METHODS Seven experts on intraocular liquid tamponades, led by a facilitator, performed a literature review on the detection of SiO emulsion. Based on the proposed ideas, a questionnaire was developed and submitted to the experts on the methods to detect SiO emulsion and the items to grade. After 2 rounds of individual ranking using a 9-point scale and related discussion, the final grading system was developed including items that reached consensus (score ≥7 from ≥75% of members). RESULTS The agreed ITEMS grading system includes the identification of SiO microbubbles and large SiO bubbles through slit-lamp biomicroscopy, gonioscopy, fundus examination under mydriasis, or ultra-wide-field fundus photography. Moreover, macular and disk optical coherence tomography are used to detect SiO-associated hyperreflective dots. CONCLUSION An evidence-based expert-led consensus was conducted to develop grading system of SiO emulsion, allowing, for the first time, homogenous collection of data on SiO emulsion. This has the potential to improve the understanding of the role and clinical relevance of SiO emulsion, allowing comparisons between different studies.
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Affiliation(s)
- Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
- Eye Center, Humanitas Gavazzeni-Castelli, Bergamo, Italy
| | | | - Rosa M Coco-Martin
- Retina Group, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Campus Miguel Delibes, Paseo de Belén, Valladolid, Spain
- Centro en Red de Medicina Regenerativa y Terapia Celular de Castilla Y León, Valladolid, Spain
- RICORS de Enfermedades Inflamatorias, Carlos III National Institute of Health, Madrid, Spain
| | | | - Martin S Spitzer
- University Medical Center Hamburg-Eppendorf, Departrment of Ophthalmology, University of Hamburg, Hamburg, Germany
| | - David H W Steel
- Sunderland Eye Infirmary, Sunderland, United Kingdom; and
- Bioscience Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - J Carlos Pastor
- Retina Group, Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Campus Miguel Delibes, Paseo de Belén, Valladolid, Spain
- Centro en Red de Medicina Regenerativa y Terapia Celular de Castilla Y León, Valladolid, Spain
- RICORS de Enfermedades Inflamatorias, Carlos III National Institute of Health, Madrid, Spain
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11
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Kasikci M, Sul S, Simsek HC, Karalezli A, Simsek M, Korkmaz S. Effect of the Presence of Silicone Oil in the Anterior Chamber After Complicated Retinal Detachment Surgery on Corneal Morphology by In Vivo Confocal Microscopy. Curr Eye Res 2023; 48:704-711. [PMID: 37081812 DOI: 10.1080/02713683.2023.2202366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/23/2023] [Accepted: 04/09/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE This study evaluated the corneal endothelium, stromal keratocytes, subbasal nerve number and density in patients with silicone oil transferred to the anterior camera after pseudophakic complicated retinal detachment surgery by in vivo laser scanning confocal microscopy (IVLSCM). METHODS Sequential measurements were made by IVLSCM between 3-6 months after surgery in two groups of patients: a) with silicon oil migration (Group 1) and without silicone oil migration (Group 2). RESULTS A total of 63 cases (Group 1: 32 and Group 2: 31) were examined. The mean ages of patients were 65 ± 12 and 61 ± 11 and M/F ratio was 18/14 and 17/14, respectively. Mean intraocular pressures were 16.60 ± 4.60 and 15.75 ± 5.70 mm Hg, respectively. Changes were detected by IVLSCM mostly on the superior part of the cornea. A significant decrease in endothelial cell density and the number was detected in group 1 (2072 ± 116.2 cells/mm2 vs 2752 ± 512.3 cells/mm2; p < 0.001). Significant increases in posterior keratocyte density and stromal hyperreflective deposits were observed in group 1 (887 ± 45.8 cells/mm2 vs 725 ± 65.8 cells/mm2; p < 0.001). A significant negative correlation was observed between the size of stromal deposits and endothelial cell density (r=-0.758; p < 0.001). The number and density of corneal subbasal nerves were significantly lower in group 1 (1.8 ± 0.8 and 4.8 ± 1.2 vs 420 ± 101 and 701 ± 112 µm/square; p < 0.001). CONCLUSION IVLSCM is a useful tool for the early detection of corneal abnormalities caused by silicone oil injection. This study verified silicone oil's detrimental effect on the corneal endothelium and revealed stromal changes in the anterior chamber, which we believe can be also been associated with the presence of silicone oil.
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Affiliation(s)
- Murat Kasikci
- Department of Ophthalmology, Mugla Sitki Kocman University Education and Research Hospital, Mugla, Turkey
| | - Sabahattin Sul
- Department of Ophthalmology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey
| | - Huseyin Cem Simsek
- Department of Ophthalmology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey
| | - Aylin Karalezli
- Department of Ophthalmology, Mugla Sitki Kocman University School of Medicine, Mugla, Turkey
| | - Merve Simsek
- Department of Ophthalmology, Mugla Sitki Kocman University Education and Research Hospital, Mugla, Turkey
| | - Safak Korkmaz
- Department of Ophthalmology, Giresun University, Giresun, Turkey
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12
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Wang S, Liu Y, Du Y, Bao H, Zhu J, Liu X. Influencing factors of low vision 2 years after vitrectomy for proliferative diabetic retinopathy: an observational study. BMC Ophthalmol 2023; 23:309. [PMID: 37430223 DOI: 10.1186/s12886-023-03071-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/05/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Proliferative diabetic retinopathy (PDR) can seriously affect the vision and quality of life of patients. The present study aimed to evaluate the clinical effect of vitrectomy for PDR by observing visual recovery and postoperative complications and to explore the factors influencing low vision. METHODS This was a case series observational study. Consecutive eyes of patients with PDR who underwent 23G vitrectomy in our hospital within one year (2019.11-2020.11) were collected and followed up for more than 2 years. Patients' visual acuity, surgical complications and management were collected before the operation and during the follow-up. Decimal visual acuity was recorded and converted to the logarithm of the minimal angle of resolution (logMAR) for statistical analysis. Excel was used to establish a database, and SPSS 22.0 statistical software was used for data analysis. RESULTS A total of 127 patients and 174 eyes were included in the study. The mean age was 57.8 years. The best corrected visual acuity (BCVA) was < 0.3 in 89.7% of eyes before surgery and ≥ 0.3 in 48.3% of eyes after surgery. Among 174 eyes, visual acuity improved in 83.3%. There was no change in 8.6% of eyes, while 8.1% of eyes had decreased visual acuity after surgery. The average logMAR visual acuity was 1.5 ± 0.7 before surgery and 0.7 ± 0.6 after surgery, indicating significant improvement (p < 0.05). Logistic regression analysis showed that intraoperative silicone oil filling and postoperative complication were significant risk factors for postoperative low vision, while preoperative pseudophakic lens and postoperative intra vitreal injection of anti-VEGF were protective factors for vision recovery (p < 0.05). The incidence of postoperative complications was 15.5%, top three of which were vitreous haemorrhage, neovascular glaucoma and traction retinal detachment. CONCLUSION Vitrectomy is safe and effective in the treatment of PDR with few complication. Postoperative intra vitreal injection of anti-VEGF is a protective factor for vision recovery. TRIAL REGISTRATION The trial registration number is ChiCRT2100051628, and the date of registration was September 28, 2021.
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Affiliation(s)
- Shengxia Wang
- Department of Ophthalmology, , The Affiliated Taian City Central Hospital of Qingdao University, No.29 Longtan Road, Taian, 271000, Shandong, People's Republic of China.
| | - Yongjun Liu
- Department of Ophthalmology, , The Affiliated Taian City Central Hospital of Qingdao University, No.29 Longtan Road, Taian, 271000, Shandong, People's Republic of China
| | - Yunhong Du
- Department of Ophthalmology, , The Affiliated Taian City Central Hospital of Qingdao University, No.29 Longtan Road, Taian, 271000, Shandong, People's Republic of China
| | - Huijing Bao
- Department of Ophthalmology, , The Affiliated Taian City Central Hospital of Qingdao University, No.29 Longtan Road, Taian, 271000, Shandong, People's Republic of China
| | - Junli Zhu
- Department of Ophthalmology, , The Affiliated Taian City Central Hospital of Qingdao University, No.29 Longtan Road, Taian, 271000, Shandong, People's Republic of China
| | - Xin Liu
- School of Clinical and Basic Medicine, Shandong First Medical University (Shandong Academy of Medical Sciences), Taian, 271000, Shandong, People's Republic of China.
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Moussa G, Tadros M, Ch'ng SW, Ferrara M, Kalogeropoulos D, Sharma A, Lett KS, Mitra A, Tyagi AK, Andreatta W. Unexplained visual loss in retinal detachment repair: comparing gas, silicone oil and heavy silicone oil by multivariable regression. Int J Retina Vitreous 2023; 9:30. [PMID: 37120629 PMCID: PMC10148464 DOI: 10.1186/s40942-023-00466-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/03/2023] [Indexed: 05/01/2023] Open
Abstract
PURPOSE To measure the proportion of unexplained and all causes of visual loss following primary rhegmatogenous-retinal-detachment (RRD) repair, comparing gas tamponade (SF6, C2F6, C3F8), silicone oil (SO, 1000cs and 5000cs) and heavy silicone oil (Densiron). METHODS Retrospective, continuous, comparative study from 01/1/2017-31/5/2021. All primary RRDs were included after successful removal of SO and Densiron. Primary failures were excluded. Visual loss was defined as reduction of ≥0.30 logMAR units. Multivariable binary-logistic and linear regression models to compare tamponade, and all cases of unexplained visual loss and logMAR gain were performed. Covariates included age, ocular co-morbidities, pre-op vision, macula-status, high-myopia, giant-retinal-tear (GRT), perfluorocarbon-use, combined buckle/PPV, PVR-C, retinectomy, tamponade agent and post-operative lens status. RESULTS Of 1,012 primary RRDs, we found an incidence of unexplained visual loss in 15/1012 (1.5%, SF6:1/341[0.3%], C2F6:4/338[1.2%], C3F8:2/239[0.8%], Densiron:0/33[0.0%], SO-1000cs:5/43[11.6%] and SO-5000cs:3/18[16.7%]), and visual loss of all causes in 57/1012 (5.6%, SF6:13/341[3.8%], C2F6:14/338[4.1%], C3F8:15/239[6.3%], Densiron:2/33[6.1%], SO-1000cs:9/43[20.9%] and SO-5000cs:4/18[22.2%]). On multivariable binary-logistic regression, we report that macula-on RRD (Odds-Ratio[OR]5.7,95% Confidence-interval[CI]1.2-28.2, p=0.032), GRT (OR35.0,CI 2.0-617.3, p=0.015), combined buckle/PPV (OR37.7,CI 2.0-711.4, p=0.015), SO1000cs (OR86.6,CI 5.6-1,348.0), p=0.001) and 5000cs (OR37.2,CI 1.3-1,101.5, p=0.036) (Reference-tamponade:SF6) were associated with unexplained visual loss. Duration of oil tamponade was not linked to increase in unexplained visual loss (p=0.569). CONCLUSIONS Correlation between SO in detachment repairs and unexplained visual loss has been established, however incidence with HSO has not been compared to other agents. This study demonstrates that although SO was linked with risk-adjusted increased unexplained visual loss relative to gas tamponade, no such association was found for Densiron, on multivariable analysis.
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Affiliation(s)
- George Moussa
- Birmingham and Midland Eye Centre and Academic Unit of Ophthalmology, University of Birmingham, Birmingham, UK.
- Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK.
| | - Maria Tadros
- Birmingham and Midland Eye Centre and Academic Unit of Ophthalmology, University of Birmingham, Birmingham, UK
| | - Soon Wai Ch'ng
- Birmingham and Midland Eye Centre and Academic Unit of Ophthalmology, University of Birmingham, Birmingham, UK
| | | | - Dimitrios Kalogeropoulos
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ash Sharma
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
| | - Kim Son Lett
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
| | - Arijit Mitra
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
| | - Ajai K Tyagi
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
| | - Walter Andreatta
- Birmingham Midlands Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
- Kantonsspital Winterthur, Brauerstrasse 15, 8400, Winterthur, Switzerland
- University of Zurich, Rämistrasse 71, 8006, Zurich, Switzerland
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AlAmry M, Alahareef E, Aljebreen A, AlJudaibi R. Preoperative and Intraoperative Spontaneous Scleral Rupture: A Case Report and Review of Literature. Middle East Afr J Ophthalmol 2023; 30:59-61. [PMID: 38435109 PMCID: PMC10903711 DOI: 10.4103/meajo.meajo_71_23] [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: 05/03/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 03/05/2024] Open
Abstract
Scleral rupture is a rare but significant complication that can occur due to multiple risk factors. In this report, we discuss two instances of scleral perforation that happened during a silicone oil injection and after a peribulbar injection. Our study suggests that prior ocular surgery is a further risk factor for intraoperative scleral rupture, and more investigation is required to identify additional relevant risk factors that weaken the sclera.
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Affiliation(s)
- Mohammed AlAmry
- Emergency Department Senior Consultant, Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Esraa Alahareef
- General Practitioner, Ministry of Health, Medina, Saudi Arabia
| | | | - Ramzi AlJudaibi
- Ophthalmology Consultant, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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15
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Retinal and Corneal Changes Associated with Intraocular Silicone Oil Tamponade. J Clin Med 2022; 11:jcm11175234. [PMID: 36079165 PMCID: PMC9457190 DOI: 10.3390/jcm11175234] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/13/2022] [Accepted: 09/01/2022] [Indexed: 12/22/2022] Open
Abstract
Silicone oils (SO) are used as long-term intraocular tamponades and have an irreplaceable role in vitreoretinal surgery. They can, however, be associated with multiple and potentially severe complications, involving different ocular tissues, in particular retina and cornea. Recent advances in ophthalmic imaging have allowed the precise characterization of retinal and corneal microstructural changes, at a subclinical level. This detailed analysis of SO-related retinal and corneal changes has improved our understanding of their pathogenesis and offer the potential for optimized monitoring and management of patients with SO-filled eyes. This review aims to provide clinicians and ophthalmic scientists with an updated and comprehensive overview of the corneal and retinal changes associated with SO tamponade.
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Usategui-Martín R, De Luis-Román DA, Fernández-Gómez JM, Ruiz-Mambrilla M, Pérez-Castrillón JL. Vitamin D Receptor ( VDR) Gene Polymorphisms Modify the Response to Vitamin D Supplementation: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14020360. [PMID: 35057541 PMCID: PMC8780067 DOI: 10.3390/nu14020360] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 11/29/2022] Open
Abstract
The vitamin D receptor (VDR), a member of the nuclear receptor superfamily of transcriptional regulators, is crucial to calcitriol signalling. VDR is regulated by genetic and environmental factors and it is hypothesised that the response to vitamin D supplementation could be modulated by genetic variants in the VDR gene. The best studied polymorphisms in the VDR gene are Apal (rs7975232), BsmI (rs1544410), Taql (rs731236) and Fokl (rs10735810). We conducted a systematic review and meta-analysis to evaluate the response to vitamin D supplementation according to the BsmI, TaqI, ApaI and FokI polymorphisms. We included studies that analysed the relationship between the response to vitamin D supplementation and the genotypic distribution of these polymorphisms. We included eight studies that enrolled 1038 subjects. The results showed no significant association with the BsmI and ApaI polymorphisms (p = 0.081 and p = 0.63) and that the variant allele (Tt+tt) of the TaqI polymorphism and the FF genotype of the FokI variant were associated with a better response to vitamin D supplementation (p = 0.02 and p < 0.001). In conclusion, the TaqI and FokI polymorphisms could play a role in the modulation of the response to vitamin D supplementation, as they are associated with a better response to supplementation.
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Affiliation(s)
- Ricardo Usategui-Martín
- IOBA, University of Valladolid, 47011 Valladolid, Spain
- Cooperative Health Network for Research (RETICS), Oftared, National Institute of Health Carlos III, ISCIII, 47011 Madrid, Spain
- Correspondence: (R.U.-M.); (J.-L.P.-C.)
| | - Daniel-Antonio De Luis-Román
- Department of Endocrinology, Clinical University Hospital, 47002 Valladolid, Spain;
- Department of Medicine, Faculty of Medicine, University of Valladolid, 47002 Valladolid, Spain
- Instituto de Endocrinología y Nutrición (IENVA), University of Valladolid, 47002 Valladolid, Spain
| | - José María Fernández-Gómez
- Department of Cell Biology, Histology and Pharmacology, Faculty of Medicine, University of Valladolid, 47002 Valladolid, Spain;
| | - Marta Ruiz-Mambrilla
- Department of Surgery, Faculty of Medicine, University of Valladolid, 47002 Valladolid, Spain;
| | - José-Luis Pérez-Castrillón
- Department of Medicine, Faculty of Medicine, University of Valladolid, 47002 Valladolid, Spain
- Instituto de Endocrinología y Nutrición (IENVA), University of Valladolid, 47002 Valladolid, Spain
- Department of Internal Medicine, Río Hortega University Hospital, 47002 Valladolid, Spain
- Correspondence: (R.U.-M.); (J.-L.P.-C.)
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