Foldable capsular vitreous body implantation for treatment of traumatic retinal detachment: two case reports

Study on the efficacy and safety of foldable capsular vitreous body in the severe retinal detachment eyes

BACKGROUND

This study was to evaluate the efficacy and safety of the implantation of foldable capsular vitreous body (FCVB) in severe retinal detachment eyes.

METHODS

A retrospective study in retinal detachment eyes was performed at Shandong Provincial Hospital Affiliated to Shandong First Medical University. A standard three-port pars plana vitrectomy was performed, and the FCVB was triple folded and implanted into the vitreous cavity. The silicone oil (SO) was then injected into the capsule of the FCVB to support the retina and eye. During the follow-up period, The treated eyes were examined by ophthalmoscopy, fundus photography, and tonometry. B-scan ultrasonography, optical coherence tomography (OCT), and computed tomography (CT), were also performed.

RESULTS

From May 2020 to November 2021, 31 cases with severe retinal detachment were enrolled in the study. The postoperative follow-up time gradient ranged from 1 to 72 weeks, At various observation time points during the 72 weeks after surgery, The postoperative IOP was maintained at around 10 mmhg at various time points, with a slight decrease compared to the preoperative IOP (14.2 ± 4.6 mmHg n = 18), and was statistically significant. 9 of 31 patients had clear refractive media, both fundus and OCT showed retinal reattachment, OCT showed the 200 μm thick FCVB capsule support retina. The remaining 22 patients with unclear refractive media, B-scan showed arcuate hyperechoes in front of the retina. There was also no significant difference in visual acuity compared to preoperative. The FCVB was well positioned in the vitreous cavity, and no serious complications such as endophthalmitis, glaucoma, silicone oil emulsification, product exposure, or sympathetic uveitis were found.

CONCLUSIONS

FCVB has retinal support with certain ability to maintain IOP and eye morphology and avoid eye removal in patients with severe retinal detachment during the 72-week observation period.

Evaluation of Foldable Capsular Vitreous Body Implantation Surgery

Background

Foldable capsular vitreous body (FCVB), a novel artificial vitreous substitute product, has been used clinically in recent years. The aim of this study was to evaluate the outcomes and complications of FCVB implantation surgery during the postoperative period.

Methods

We performed a prospective, nonrandomized study from November 2021 to March 2022. Eight patients with severe retinal detachment that could not be easily reattached were included in this study. Before and after surgery, visual acuity (VA), intraocular pressure (IOP), slit-lamp microscopy, optical coherence tomography (OCT), B-scan and CT were performed.

Results

After the operation, the FCVB was well distributed in the vitreous cavity and supported the retina according to the B-scan and CT images. During the follow-up period, no vitreous hemorrhage or retinal detachment was found in any of the patients. On the first postoperative day, the average IOP increased from 9.6 ± 7.7 mmHg preoperatively to 13.8 ± 14.3 mmHg. Although the IOP of two patients fell outside the normal range, IOP was finally held steady after the fifth postoperative day in all cases. In addition, three patients (37.5%) experienced eye ache, and after taking a Saridon tablet, the pain was greatly alleviated. Moreover, no adverse events, such as silicone oil (SO) spillage and emulsification or serious complications, were observed.

Conclusion

The current vitreous substitute FCVB is effective and safe for treating complicated retinal detachments in ophthalmic applications. Further multiple-center clinical designs should focus on indications and complications of FCVB during long-term follow-up periods.