scholarly journals Silicone Oil Emulsification after Vitrectomy for Rhegmatogenous Retinal Detachment

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Jian Yu ◽  
Yuan Zong ◽  
Chunhui Jiang ◽  
Haohao Zhu ◽  
Guohua Deng ◽  
...  

Purpose. To investigate the characteristics of silicone oil (SO) emulsification after vitrectomy for rhegmatogenous retinal detachment and their possible correlations with clinical factors. Methods. The first 2 mL of washing out fluid after SO removal was collected, and used for the measurement of the size and number of SO droplets using a Multisizer® 3 Coulter counter (Beckman Coulter, USA). The correlations between SO droplets and clinical factors were analyzed. Results. A total of 38 patients (23 males, 15 females) who underwent primary PPV with SO injection for RRD and whose retina stayed attached for ≥3 months after SO removal were included in the study. The average number of oil droplets was 1.96 × 106 ± 3.95 × 106/mL (range 0.17 × 106 to 21.71 × 106/ml), and 80.8% (range 64.23%–99.07%) of the droplets were 1-2 μm in diameter. The total number of emulsified SO droplets was not correlated with any clinical factor (all P>0.05). When the emulsified SO droplets were divided into groups by their diameter, multiple linear regression revealed that age was negatively correlated with the numbers of 5–7-μm-diameter and 7–12-μm-diameter droplets (both P<0.05). Patients using antiglaucoma medications had more 5–7-μm-diameter and 7–12-μm-diameter droplets than those not using (all P<0.05). Conclusion. Using a Multisizer® Coulter counter, we successfully determined the number and size of SO droplets after emulsification. We found that the number of 5–12-μm-diameter droplets was higher in younger-age patients and was higher in patients using antiglaucoma eyedrops.

2021 ◽  
Author(s):  
Hongmei Zhao ◽  
Jian Yu ◽  
Yuan Zong ◽  
Chunhui Jiang ◽  
Haohao Zhu ◽  
...  

Abstract Background To investigate the characteristics of silicone oil (SO) emulsification after vitrectomy for rhegmatogenous retinal detachment (RRD) and possible correlations with clinical factors. Methods Patients who underwent primary pars plana vitrectomy with SO injection for RRD followed by SO removal at the Eye and ENT Hospital of Fudan University between January 2016 and January 2020 were included. Ultrasound biomicroscopy (UBM) images of the anterior segment were taken before SO removal. Eight signs of SO emulsification in the UBM images were graded as 1 (present) or 0 (not present) and the grades for all signs in each eye were summed. Correlations between SO emulsification grade and clinical factors were determined. Results A total of 118 patients (118 eyes) were enrolled in this study. Emulsified SO particles were found in all 118 eyes (100%). The eight signs were more frequently detected in the superior part of the eye. The mean total SO emulsification grade was 19.99 ± 12.98 (range: 1–36). Younger age and male (both P < 0.05) were associated with higher total SO emulsification grade. Patients with intraocular pressure (IOP) > 21 mmHg or the use of antiglaucoma medications at the time of SO removal had a higher total SO emulsification grade, were younger, and were more frequently male (all P < 0.05) than patients without ocular hypertension. Conclusions UBM could play an important role in the diagnosis and grading of SO emulsification. Younger patients and males are more prone to SO emulsification, which may lead to elevated IOP.


2022 ◽  
Vol 8 ◽  
Author(s):  
Hongmei Zhao ◽  
Jian Yu ◽  
Yuan Zong ◽  
Chunhui Jiang ◽  
Haohao Zhu ◽  
...  

Purpose: To investigate the characteristics of silicone oil (SO) emulsification after vitrectomy for rhegmatogenous retinal detachment (RRD) and possible correlations with clinical factors.Methods: Patients who underwent primary pars plana vitrectomy with SO injection for RRD followed by SO removal at the Eye and ENT Hospital of Fudan University between January 2016 and January 2020 were included. Ultrasound biomicroscopy (UBM) images of the anterior segment were taken before SO removal. Eight signs of SO emulsification in the UBM images were graded as 1 (present) or 0 (not present) and the grades for all signs in each eye were summed. Correlations between SO emulsification grade and clinical factors were determined.Results: A total of 118 patients (118 eyes) were enrolled in this study. Emulsified SO particles were found in all 118 eyes (100%). The eight signs were more frequently detected in the superior part of the eye. The mean total SO emulsification grade was 19.99 ± 12.98 (range: 1–36). Younger age and male (both P &lt; 0.05) were associated with higher total SO emulsification grade. Patients with intraocular pressure (IOP) &gt; 21 mmHg or the use of antiglaucoma medications at the time of SO removal had a higher total SO emulsification grade, were younger, and were more frequently male (all P &lt; 0.05) than patients without ocular hypertension.Conclusions: UBM could play an important role in the diagnosis and grading of SO emulsification. Younger patients and males are more prone to SO emulsification, which may lead to elevated IOP.


2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Jian Yu ◽  
Yuan Zong ◽  
Ye Tan ◽  
Chunhui Jiang ◽  
Gezhi Xu

Purpose. To compare the efficacy of passive drainage (PD) and repeated fluid-air (FA) exchange for removing emulsified silicone oil (SO) droplets. Methods. Twenty rhegmatogenous retinal detachment (RRD) patients who underwent primary pars plana vitrectomy (PPV) with SO tamponade were randomly and evenly divided into two groups for PD and FA exchange. Once the bulk of SO was removed, the first 2 mL of the washout fluid was collected, and then, another 2 mL of the washout fluid was collected after PD or FA exchange. The size and number of SO droplets in the washout fluid were measured using a Coulter counter (Multisizer 3, Beckman Coulter, Indianapolis, IN, USA). The efficiencies of FA exchange and PD for removing emulsified SO were compared. Results. The number of SO droplets decreased significantly after FA exchange and PD. The decrease in the number of droplets was statistically significant for larger droplets (>4 µm) with PD and for all droplet sizes with FA exchange. The decrease in the number of SO droplets of <4 μm was significantly greater with FA exchange than with PD. However, at the end of the procedure, the overall number and size distribution of SO droplets were similar for both procedures. Conclusions. PD and FA exchange reduced the number of residual emulsified SO droplets after SO tamponade efficiently. FA exchange may have some advantages over PD in removing small droplets.


Author(s):  
V.Y. Markevich ◽  
◽  
T.A. Imshenetskaya ◽  
O.A. Yarmak ◽  
◽  
...  

Purpose. To study the effectiveness of extrascleral filling (ESF) using endoillumination in the surgical treatment of patients with primary rhegmatogenous retinal detachment (RRD). Material and methods. The material for the study was the data of a comprehensive clinical examination and surgical treatment by ESF method using endoillumination in 17 patients (17 eyes) with RRD. In 7 cases (41%), the macular area was involved in the detachment process. In 5 cases (29.4%), local scleral filling was performed. In the remaining 12 cases (70.6%), the local ESF was supplemented with a circling silicone element. Surgical intervention was supplemented by transscleral drainage of subretinal fluid (SRF) in 10 cases (59%) and pneumatic retinopexy with SF6 gas 50% in 8 cases (48%). Results. In the general group of patients, best corrected visual acuity (BCVA) increased from 0.35 to 0.46. In the subgroup of patients with a detached macular area, the positive dynamics is more pronounced, BCVA increased from 0.1 to 0.28. The progression of proliferative vitreoretinopathy caused the recurrence of retinal detachment in two patients (11.8%). Recurrences were diagnosed after 3 and 5 months, respectively. In both cases, a vitrectomy with tamponade of the vitreous cavity with silicone oil 5000 Cst was performed. The percentage of successful anatomical outcome after the first operation in our study was 82%. The percentage of successful achievement of the final anatomical result was 94%. In two cases, additional injection of SF6 gas into the vitreous cavity was required. Conclusion. This type of surgical treatment is an effective method of surgical treatment of patients with RRD. In our study, the successful anatomical outcome after the first operation was recorded in 82% of patients, which correlates with the data of the authors who also used this method (83–92%). Surgeons who performed surgical treatment using this technique in our study note improved workplace ergonomics when visualizing the fundus using an operating microscope and endoillumination compared with indirect ophthalmoscopy. Other teams of authors came to this conclusion as well. In our study, there were no complications associated with the introduction of a light pipe into the vitreous cavity (iatrogenic crystalline lens injury, endophthalmitis), which indicates the safety of this type of surgical treatment.


Author(s):  
R.R. Fayzrakhmanov ◽  
◽  
A.V. Sukhanova ◽  
O.A. Pavlovsky ◽  
E.D. Bosov ◽  
...  

Purpose. To compare the parameters of a light sensitivity (LS) of the central zone of a retina after vitrectomy due to reghmatogenous retinal detachment (RRD) with a silicone oil tamponade (SOT) and gas tamponade (GT). Material and methods. The study included 20 eyes after pars plana vitrectomy due to macula-off rhegmatogenous retinal detachment (RRD) by 25G. All patients were divided in 2 groups depending on the choice of the tamponade. The group I (10 eyes) included cases with the silicone oil tamponade (SOT) (1300 cSt), in the group II (10 eyes) – the gas tamponade (GT) (C2F6). The control group included contralateral eyes without ophthalmic pathology. All patients underwent standard ophthalmological examination and fundus- microperimetry (FMP) on the 30th day after removal of the SOT for the group I, or on the 30th day after the C2F6 tamponade for the group II. Results. According to FMP data, the parameter of average light sensitivity (LS) in the group I was significantly reduced, both in comparison with the group II (p=0.007) and the control group (p=0.003). Differentiation by zones in the group I revealed a decrease in each analyzed parameter in comparison with the control group (p<0.05) and a decrease in the 2nd zone (p=0.031) and the 4th zone (p=0.038) in comparison with the group II. In the 1st zone of the group I the formation of a relative scotoma was revealed in 4 cases out of 10 (40%). The parameters of light sensitivity (LS) in comparison with the control in the group II were significantly reduced when analyzed in each zone (p<0.05). A strong positive correlation was found between the Best Corrected Visual Acuity (BCVA) and the average LS in the group II (r=0.87). Conclusion. There is a decrease in the functional parameters of the retina with SOT compared with GT in the form of a decrease in the LS parameter in the 10° zone according to FMP data. Key words: retinal detachment, photosensitivity, microperimetry, silicone tamponade.


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