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Karsten M, Morello M, Lau I, Druchkiv V, Lopes IV, Dulz S, Skevas C, Spitzer MS, Mautone L. Anterior segment optical coherence tomography for the detection of silicone oil emulsification on the iris surface. Eye (Lond) 2024:10.1038/s41433-024-03261-4. [PMID: 39075263 DOI: 10.1038/s41433-024-03261-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 06/24/2024] [Accepted: 07/16/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND To investigate the presence of silicone oil (SO)-emulsification on the anterior iris surface with anterior segment optical coherence tomography (AS-OCT). METHODS In this single-center cross-sectional study, vitrectomized eyes with SO tamponade that underwent AS-OCT imaging and gonioscopy examination during the postoperative follow-up visits, were reviewed. RESULTS 45 eyes of 42 consecutive patients were included. In 35.6% of the eyes (n = 16) emulsified SO droplets were detected in the anterior chamber (AC) angle by gonioscopy and in 55.6% (n = 25) on the anterior iris surface by AS-OCT imaging. The presence of SO emulsifications in the AC-angle correlated with the presence of SO emulsifications on the anterior iris surface (OR = 13.4, 95% CI [2.179-82.130]; p = 0.005). The accuracy of the AS-OCT predicting the presence of SO in the AC-angle was 71.0% and the sensitivity was 87.5%. No significant association between SO droplets in the AC and other clinical parameters including endotamponade-duration or type of silicone oil were found. The presence of emulsified SO droplets on the anterior iris surface detected by AS-OCT was significantly correlated to postoperative IOP rise (p = 0.027). CONCLUSION AS-OCT is a suitable method for the detection of SO on the anterior iris surface. SO droplets on the iris surface correlate with elevated postoperative IOP and with the presence of SO in the AC detected by gonioscopy, therefore AS-OCT might be used as a screening method for the detection of SO migration into the AC. TRIAL REGISTRATION NUMBER Institutional Review Board of the Hamburg Medical Chamber (Ethik-Kommission der Ärztekammer Hamburg): 2023-300372-WF.
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Affiliation(s)
- Mona Karsten
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Matteo Morello
- Cardiology School, University of Brescia, Brescia, Italy
| | - Imke Lau
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vasyl Druchkiv
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ines Valente Lopes
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon Dulz
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christos Skevas
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Stephan Spitzer
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Luca Mautone
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Mladenovic T, Zivic F, Petrovic N, Njezic S, Pavic J, Kotorcevic N, Milenkovic S, Grujovic N. Application of Silicone in Ophthalmology: A Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3454. [PMID: 39063747 PMCID: PMC11278226 DOI: 10.3390/ma17143454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/01/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024]
Abstract
This paper reviews the latest trends and applications of silicone in ophthalmology, especially related to intraocular lenses (IOLs). Silicone, or siloxane elastomer, as a synthetic polymer, has excellent biocompatibility, high chemical inertness, and hydrophobicity, enabling wide biomedical applications. The physicochemical properties of silicone are reviewed. A review of methods for mechanical and in vivo characterization of IOLs is presented as a prospective research area, since there are only a few available technologies, even though these properties are vital to ensure medical safety and suitability for clinical use, especially if long-term function is considered. IOLs represent permanent implants to replace the natural lens or for correcting vision, with the first commercial foldable lens made of silicone. Biological aspects of posterior capsular opacification have been reviewed, including the effects of the implanted silicone IOL. However, certain issues with silicone IOLs are still challenging and some conditions can prevent its application in all patients. The latest trends in nanotechnology solutions have been reviewed. Surface modifications of silicone IOLs are an efficient approach to further improve biocompatibility or to enable drug-eluting function. Different surface modifications, including coatings, can provide long-term treatments for various medical conditions or medical diagnoses through the incorporation of sensory functions. It is essential that IOL optical characteristics remain unchanged in case of drug incorporation and the application of nanoparticles can enable it. However, clinical trials related to these advanced technologies are still missing, thus preventing their clinical applications at this moment.
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Affiliation(s)
- Tamara Mladenovic
- Faculty of Engineering, University of Kragujevac, Sestre Janjic 6, 34000 Kragujevac, Serbia; (T.M.); (J.P.); (N.K.); (S.M.); (N.G.)
- Institute for Information Technologies Kragujevac, University of Kragujevac, Jovana Cvijica bb, 34000 Kragujevac, Serbia
| | - Fatima Zivic
- Faculty of Engineering, University of Kragujevac, Sestre Janjic 6, 34000 Kragujevac, Serbia; (T.M.); (J.P.); (N.K.); (S.M.); (N.G.)
| | - Nenad Petrovic
- Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34000 Kragujevac, Serbia;
| | - Sasa Njezic
- Faculty of Medicine, University of Banja Luka, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina;
| | - Jelena Pavic
- Faculty of Engineering, University of Kragujevac, Sestre Janjic 6, 34000 Kragujevac, Serbia; (T.M.); (J.P.); (N.K.); (S.M.); (N.G.)
- Institute for Information Technologies Kragujevac, University of Kragujevac, Jovana Cvijica bb, 34000 Kragujevac, Serbia
| | - Nikola Kotorcevic
- Faculty of Engineering, University of Kragujevac, Sestre Janjic 6, 34000 Kragujevac, Serbia; (T.M.); (J.P.); (N.K.); (S.M.); (N.G.)
| | - Strahinja Milenkovic
- Faculty of Engineering, University of Kragujevac, Sestre Janjic 6, 34000 Kragujevac, Serbia; (T.M.); (J.P.); (N.K.); (S.M.); (N.G.)
| | - Nenad Grujovic
- Faculty of Engineering, University of Kragujevac, Sestre Janjic 6, 34000 Kragujevac, Serbia; (T.M.); (J.P.); (N.K.); (S.M.); (N.G.)
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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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4
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Choi G, An SH, Choi JW, Rho MS, Park WC, Jeong WJ, Cha HJ. Injectable alginate-based in situ self-healable transparent hydrogel as a vitreous substitute with a tamponading function. Biomaterials 2024; 305:122459. [PMID: 38199216 DOI: 10.1016/j.biomaterials.2023.122459] [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: 08/24/2023] [Revised: 12/24/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024]
Abstract
Retinal detachment and other vision-threatening disorders often necessitate vitreous body removal and tamponade injection for retina stabilization. Current clinical tamponades such as silicone oil and expansile gases have drawbacks, including patient discomfort and the need for secondary surgery. We introduce a transparent alginate-phenylboronic acid/polyvinyl alcohol composite hydrogel (TALPPH) as a novel vitreous substitute with tamponading capabilities. In vitro physicochemical, rheological, and optical characterization of in situ self-healable TALPPH was performed, and long-term biocompatibility was assessed in a rabbit model of vitrectomy retinal detachment. In vivo evaluations confirmed TALPPH's ability to inhibit retinal detachment recurrence and preserve rabbit vision without adverse effects. TALPPH's close resemblance to the natural vitreous body suggests potential as a vitreous tamponade substitute for future ophthalmological applications.
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Affiliation(s)
- Geunho Choi
- Department of Chemical Engineering, Pohang University of Science and Technology, Pohang 37673, Republic of Korea
| | - Seoung Hyun An
- Department of Ophthalmology, Dong-A University Hospital, Busan 49315, Republic of Korea
| | - Jae-Won Choi
- Department of Ophthalmology, Sungmo Eye Hospital, Busan 48064, Republic of Korea
| | - Mee Sook Rho
- Department of Pathology, Dong-A University Hospital, Busan 49315, Republic of Korea
| | - Woo Chan Park
- Department of Ophthalmology, Dong-A University Hospital, Busan 49315, Republic of Korea
| | - Woo Jin Jeong
- Department of Ophthalmology, Dong-A University Hospital, Busan 49315, Republic of Korea.
| | - Hyung Joon Cha
- Department of Chemical Engineering, Pohang University of Science and Technology, Pohang 37673, Republic of Korea; Medical Science and Engineering, School of Convergence Science and Technology, Pohang University of Science and Technology, Pohang 37673, Republic of Korea.
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5
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Ge L, Su N, Fan W, Yuan S. Risk Factors and Management of Intraocular Pressure Elevation After Vitrectomy Combined with Silicone Oil Tamponade. Int J Gen Med 2024; 17:447-456. [PMID: 38333017 PMCID: PMC10849908 DOI: 10.2147/ijgm.s446617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
Silicone oil has emerged as the common option for intraocular tamponade during complicated retina vitrectomy. However, the postoperative elevation of intraocular pressure (IOP), influenced by numerous factors, remains a significant and frequently encountered complication that poses a potential threat to vision. Extensive research has been conducted to investigate the risk factors associated with elevated IOP following silicone oil tamponade, including silicone oil viscosity, preoperative high IOP, diabetes, and lens status. This comprehensive review aims to gather and summarize the current research findings regarding the risk factors contributing to IOP elevation following silicone oil tamponade, as well as the optimal management strategies for secondary glaucoma. The analysis includes the physicochemical properties of silicone oil, preoperative and intraoperative risk factors, and the effective management of secondary glaucoma. Enhancing our understanding of the primary factors associated with silicone oil-induced IOP elevation will facilitate the guidance of timely and appropriate interventions.
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Affiliation(s)
- Lexin Ge
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Na Su
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Wen Fan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
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6
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Fan W, Zhang C, Ge L, Su N, Chen J, Song S, Wang Y, Yuan S. Prediction model for elevated intraocular pressure risk after silicone oil filling based on clinical features. Front Med (Lausanne) 2024; 10:1340198. [PMID: 38264037 PMCID: PMC10803451 DOI: 10.3389/fmed.2023.1340198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024] Open
Abstract
Background To evaluate risk factors and further develop prediction models for intraocular pressure elevation (IOP) after vitreoretinal surgery with silicone oil tamponade to support clinical management. Methods A retrospective study analyzed 1,061 eyes of 1,061 consecutive patients that presented to the Jiangsu Province Hospital between December 2015 and December 2020, the IOP was measured from the preoperative visit and at the 1-week, 1-month, 3-month, and 6-month visits, and the final postoperative visit before silicone oil removal. Four machine learning methods were used to carried out the prediction of IOP elevation: Decision Tree, Logistic Regression, Random Forest, and Gradient-Boosted Decision Trees (GBDT) based on features including demographic and clinical characteristics, preoperative factors and surgical factors. Predictors were selected based on the p-value of the univariate analysis. Results Elevated intraocular pressure developed in 26.01% of the eyes postoperatively. Elevated intraocular pressure primarily occurred within 1-2 weeks after surgery. Additionally, the majority of IOP values were distributed around 25-40 mmHg. GBDT utilizing features with p-values less than 0.5 from the hypothesis testing demonstrated the best predictive performance for 0.7944 in accuracy. The analysis revealed that age, sex, hypertension, diabetes, myopia, retinal detachment, lens status and biological parameters have predictive value. Conclusion Age, sex, hypertension, diabetes, myopia, retinal detachment, lens status and biological parameters have influence on postoperative intraocular pressure elevation for patients with silicone oil tamponade after pars plana vitrectomy. The prediction model showed promising accuracy for the occurrence of IOP elevation. This may have some reference significance for reducing the incidence of high intraocular pressure after pars plana vitrectomy combined with silicone oil filling.
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Affiliation(s)
- Wen Fan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chaohe Zhang
- Key Laboratory of High Confidence Software Technologies, Ministry of Education, Peking University, Beijing, China
- School of Computer Science, Peking University, Beijing, China
| | - Lexin Ge
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Na Su
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiaqin Chen
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Siyao Song
- School of Computer Science, Peking University, Beijing, China
- National Engineering Research Center of Software Engineering, Peking University, Beijing, China
- Software College, Northeastern University, Shenyang, China
| | - Yasha Wang
- Key Laboratory of High Confidence Software Technologies, Ministry of Education, Peking University, Beijing, China
- National Engineering Research Center of Software Engineering, Peking University, Beijing, China
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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7
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Kaźmierczak K, Żuchowski P, Stafiej J, Malukiewicz G. Functional and structural outcomes and complications after pars plana vitrectomy for severe features of proliferative diabetic retinopathy in type 1 and type 2 diabetes mellitus. PLoS One 2023; 18:e0288805. [PMID: 37471387 PMCID: PMC10358898 DOI: 10.1371/journal.pone.0288805] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 07/03/2023] [Indexed: 07/22/2023] Open
Abstract
PURPOSE To evaluate the functional and structural outcomes as well as postoperative complications after pars plana vitrectomy (PPV) for severe features of proliferative diabetic retinopathy (PDR) in type 1 and type 2 diabetes mellitus (DM) patients. METHODS Twenty two eyes of type 1 diabetics (DM1 group) and 27 eyes of type 2 diabetics (DM2 group) were included. Best corrected visual acuity (BCVA), intraocular pressure (IOP), postoperative structural changes in optical coherence tomography (OCT) and postoperative complications such as recurrent vitreous haemorrhage, diabetic macular oedema, secondary glaucoma and persistent tractional retinal detachment (TRD) were assessed and compared between the two groups. RESULTS Complete reattachment of retina was achieved in 88.9% from the DM1 group and in 95.5% from the DM2 group and remained attached in follow-up. BCVA in DM2 group was significantly lower preoperatively (p = 0.04). Mean postoperative BCVA significantly improved in both studied groups, but it was more evident in eyes of type 2 diabetics compared to type 1 diabetics. In eyes in the DM1 group there was perceptible stabilisation of BCVA. Poor visual acuity or lack of improvement in BCVA in the DM1 group was related to preoperative subretinal haemorrhage in macular region, and TRD involving macula, whereas in the DM2 group-to preoperative subretinal haemorrhage and neovascular glaucoma. The postoperative structural changes (disruption of EZ and ELM) were observed more often in DM2 group, but had the greatest impact on BCVA in eyes of type 1 DM. Complications after PPV for PDR were rare and hadn't a significant influence on the final functional outcomes in both groups. CONCLUSIONS Functional improvement after PPV for severe features of proliferative diabetic retinopathy were more noticeable in patients with type 2 DM. Postoperative structural changes had more negative impact on BCVA in type 1 diabetics.
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Affiliation(s)
- Karolina Kaźmierczak
- Department of Ophthalmology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Paweł Żuchowski
- Clinic of Rheumatology and Connective Tissue Diseases, Jan Biziel University Hospital No. 2, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Joanna Stafiej
- Department of Ophthalmology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Grażyna Malukiewicz
- Department of Ophthalmology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
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Rizwan A, Javaid RMM, Latif S, Sarwar MS, Khan AA. Comparison of residual silicone oil index after removal of silicone oil with fluid-air versus oil-fluid exchange. Pak J Med Sci 2023; 39:439-443. [PMID: 36950406 PMCID: PMC10025723 DOI: 10.12669/pjms.39.2.6243] [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: 02/20/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
Objectives To compare the effectiveness of fluid-air exchange with silicone oil-fluid exchange in reducing the residual silicone oil (SO) droplets after the removal of SO. Methods This was a prospective, quasi-experimental study conducted from October 2021 to February 2022 at Eye Unit-III, COAVS, Mayo Hospital, Lahore. Sixty-one patients with siliconized eyes underwent removal of SO with two different techniques and were divided into fluid-air exchange and oil-fluid exchange groups. To quantify the residual silicone droplets objectively, B-scan echographic images were analyzed within seven days of surgery. Silicone oil index (SOI) which is the amount of residual SO droplets/vitreal area in the images was calculated with the help of imagej software. Results The residual SOI of the fluid-air exchange group (0.99 ± 1.76%) was significantly lower than the oil-fluid exchange group (3.25 ± 3.85%). The SOI is positively correlated with the duration of tamponade, preoperative intraocular- pressure and axial length. Persistent IOP elevation post-operatively was seen in 16.67% individuals in the fluid-air exchange group and 54.8% individuals in the oil-fluid exchange group. Conclusion Fluid-air exchange group was found to be superior in reducing residual SO droplets than the oil-fluid exchange group.
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Affiliation(s)
- Amna Rizwan
- Amna Rizwan, Eye Unit-III, Mayo Hospital Lahore, Pakistan
| | | | - Sidrah Latif
- Sidrah Latif, Eye Unit-III, Mayo Hospital Lahore, Pakistan
| | | | - Asad Aslam Khan
- Asad Aslam Khan, Eye Unit-III, Mayo Hospital Lahore, Pakistan
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Weber C, Liegl R, Mercieca K. Der Intraokulardruck nach Netzhauteingriffen. Klin Monbl Augenheilkd 2022; 239:1094-1100. [PMID: 35915970 DOI: 10.1055/a-1914-2828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Zusammenfassung - Deutsch
Netzhauteingriffe können zu einem erhöhten Augeninnendruck führen. Die Ursachen hierfür sind vielfältig und schließen mechanische aber auch pharmakologische Gründe ein. Die Therapie besteht zunächst aus einer Lokaltherapie mit drucksenkenden Augentropfen. Bei unzureichendem Ansprechen sind chirurgische Eingriffe indiziert.
Summary - English
Retinal surgery can lead to an elevated intraocular pressure. The causes for this are manifold and include mechanical but also pharmacological reasons. Therapy consists initially of topical therapy with pressure-lowering eye drops. In case of inadequate response, surgical interventions are indicated.
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Affiliation(s)
- Constance Weber
- Augenheilkunde, Universitätsklinikum Bonn Augenklinik, Bonn, Germany
| | - Raffael Liegl
- Department of Ophthalmology, Universitätsklinikum Bonn Augenklinik, Bonn, Germany
| | - Karl Mercieca
- Department of Ophthalmology, Universitätsklinikum Bonn Augenklinik, Bonn 53127, Germany
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10
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Surgical Treatment in Silicone Oil-Associated Glaucoma. Diagnostics (Basel) 2022; 12:diagnostics12041005. [PMID: 35454053 PMCID: PMC9031548 DOI: 10.3390/diagnostics12041005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 01/27/2023] Open
Abstract
Glaucoma is a vision threatening, not uncommon complication of eyes that have undergone pars plana vitrectomy with silicone oil endotamponade. Although most patients respond well to medical antiglaucoma therapy, there are refractory cases where surgery is required to control the intraocular pressure. This review, following a comprehensive literature search in the Medline database, aims to present the most important surgical techniques currently in use for glaucoma associated with silicone oil endotamponade and their indication depending on the mechanism of glaucoma. In cases of pupillary block, the presence of a patent iridotomy or iridectomy must be ensured, either by laser or surgically. When silicone oil is in excess and whenever the retinal status permits it, partial or complete removal of the silicone oil should be performed. Trabeculectomy has shown higher failure rates and more complications in these cases compared to other indications, so alternate methods are warranted. For very high intraocular pressures, glaucoma drainage devices and transscleral cyclophotocoagulation are the most used options, with good efficacy and safety profiles, although rarely they may have serious complications. The Ex-PRESS mini shunt has shown excellent results and lower rates of complications. For less important IOP elevations, minimally invasive glaucoma surgery and selective laser trabeculoplasty may be used, either alone or in conjunction with other methods.
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11
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Coman (Cernat) CC, Munteanu M, Patoni (Popescu) SI, Mușat O. Silicone oil complications in vitreoretinal surgery. Rom J Ophthalmol 2022; 66:299-303. [PMID: 36589335 PMCID: PMC9773106 DOI: 10.22336/rjo.2022.55] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
Objective: To illustrate the complications in subjects who experienced posterior vitrectomy and internal tamponade with silicone oil. Design: Prospective, observational, longitudinal, descriptive, series of cases. Material and methods: Patients who underwent posterior vitrectomy and internal tamponade with silicone oil of 1000 centistokes, from April to October 2021, were considered. All subjects included in the study had a complete ophthalmic examination pre and postoperatively on first day, first week and 1 to 6 months, and were assessed the best corrected visual acuity, ocular tension (raised > 21 mmHg, hypotony < 5 mmHg), emulsification, keratopathy, cataracts and posterior pole. Results: 40 eyes of 40 patients were considered; twenty women and 20 men, with an average age of 63 years (range 46 to 77 years). Conclusions: Complications are brief, treated medically or surgically, with better prognosis.
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Affiliation(s)
- Corina Cristina Coman (Cernat)
- Department of Ophthalmology, “Victor Babeș” University of Medicine and Pharmacy, Timișoara, Romania
,Department of Ophthalmology, “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania
| | - Mihnea Munteanu
- Department of Ophthalmology, “Victor Babeș” University of Medicine and Pharmacy, Timișoara, Romania
| | | | - Ovidiu Mușat
- Department of Ophthalmology, “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania
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12
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Zeng B, Wang Q, Sui G, Wang M, Xie W, Fu J. Foldable capsular vitreous body implantation for treatment of traumatic retinal detachment: two case reports. J Int Med Res 2021; 49:300060521990257. [PMID: 33563057 PMCID: PMC7879493 DOI: 10.1177/0300060521990257] [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] [Indexed: 12/02/2022] Open
Abstract
Retinal detachment caused by severe ocular trauma is a type of refractory vitreoretinal disease. Current treatment methods include vitrectomy combined with silicone oil tamponade. However, long-term use of silicone oil tamponade has various complications, including a risk of silicone oil dependence that eventually leads to eyeball atrophy and enucleation. Foldable capsular vitreous bodies (FCVBs) offer a good solution for these problems. However, FCVBs have not been used in large-scale clinical applications and few cases have been reported in the published literature. The main use of FCVBs, based on current evidence, is in the treatment of the relatively few (but important) patients whose eyes have no visual potential; the aim of treatment in these patients is globe preservation, rather than restoration of vision. Here, we describe two patients who underwent FCVB implantation. The findings in these patients indicated that FCVBs can effectively support the vitreous cavity and detached retina. FCVB implantation may thus offer a safe and effective method for treatment of severe retinal detachment, avoiding the inconvenience caused by silicone oil dependence and enucleation. To confirm its long-term usefulness in clinical applications, many additional case reports are needed.
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Affiliation(s)
- Baihui Zeng
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Qian Wang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Guiqin Sui
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Mingxuan Wang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Wei Xie
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Jinling Fu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
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