Long-Lasting Endotamponades in Vitreoretinal Surgery

Wagenfeld, Lars; Zeitz, Oliver; Skevas, Christos; Richard, Gisbert

doi:10.1159/000298749

Cited by 21 publications

(26 citation statements)

References 153 publications

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“…In addition, young patients are at a high risk for developing severe ocular inflammation. Recent developments in PFCL have focused on perfluorocarbon-perfused vitrectomy, in which oxygenated or nonoxygenated PCFL is used instead of balanced salt solutions [20, 25, 26]. …”

Section: Vitreous Substitutesmentioning

confidence: 99%

Vitreous Substitutes: Old and New Materials in Vitreoretinal Surgery

Alovisi

Panico

Sanctis

et al. 2017

Journal of Ophthalmology

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Recent developments in vitreoretinal surgery have increased the need for suitable vitreous substitutes. A successful substitute should maintain all the physical and biochemical properties of the original vitreous, be easy to manipulate, and be long lasting. Substitutes can be gaseous or liquid, both of which have associated advantages and disadvantages related to their physical properties and use. Furthermore, new surgical techniques with smaller vitreoretinal instruments have driven the use of more viscous substitutes. In this review, we analyze and discuss the most frequently used vitreous substitutes and look ahead to future alternatives. We classify these compounds based on their composition and structure, discuss their clinical use with respect to their associated advantages and disadvantages, and analyze how new vitreoretinal surgical techniques have modified their use.

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Section: Vitreous Substitutesmentioning

confidence: 99%

Vitreous Substitutes: Old and New Materials in Vitreoretinal Surgery

Alovisi

Panico

Sanctis

et al. 2017

Journal of Ophthalmology

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“…Hydrogenated hydrofluorocarbon liquids (HFCLs) were developed with reduced specific gravity values and increased lipophilic properties. HFCLs, such as F6H6, F6H8, O44, and O62, were developed to substitute for PFCLs as long-term tamponade in vitreoretinal surgery [68–71]. Due to their properties, these compounds have the potential to remove intraocular silicon oil remnants [72, 73].…”

Section: Recent Developments In Pfclsmentioning

confidence: 99%

Perfluorocarbon Liquid: Its Application in Vitreoretinal Surgery and Related Ocular Inflammation

Liu

et al. 2014

BioMed Research International

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The application of perfluorocarbon liquids has been well acclaimed in vitreoretinal surgery. Its unique physical properties make it an ideal intraoperative tool to improve the efficiency and safety of surgical procedures in complicated cases. The main functions of perfluorocarbon liquids in vitreoretinal surgery include relocating and fixing the detached retina, displacing the subretinal and subchoroidal to fluid anteriorly, revealing proliferative vitreous retinopathy (PVR) for further maneuvers, protecting the macula from exposure to chemicals with potential toxicity, and assisting the removal of foreign body. The related clinical applications include retinal detachment with severe proliferative vitreoretinopathy, giant tear, diabetic retinopathy (DR), retinopathy of prematurity (ROP), and posterior dislocated crystalline and intraocular lenses. The application of perfluorocarbon liquids has been expended over the past fewer years. Several PFCLs related ocular inflammations have been observed in in vitro studies, animal studies, and clinical follow-up. The complete removal of PFCLs is recommended at the end of the surgery in most cases.

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“…Silicone oil has had an important use as a long-acting endotamponade agent in vitreoretinal surgery for several decades [ 1 ]. It is used in particular following surgery for complex retina detachments such as in giant retina tear, trauma, viral retinitis, proliferative vitreoretinopathy (PVR) and chronicity [ 2 ]. Infective endophthalmitis is a dreaded severe complication of intraocular surgery due to intraocular infection by microbes.…”

Section: Introductionmentioning

confidence: 99%

Burkholderia cepacia, a cause of post pars plana vitrectomy silicone oil related endophthalmitis: clinico-pathological presentation and outcome of management

Okonkwo¹,

Hassan²,

Oderinlo³

et al. 2018

Int J Retin Vitr

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AimTo report the long-term outcome of the management of a series of culture proven post pars plana vitrectomy endophthalmitis in which the infective agent was in the silicone oil used as an endotamponade. The isolates were Burkholderia cepacia and Pseudomonas aeruginosa.MethodA retrospective interventional reporting of a series consisting of a cluster of five cases.CasesFive consecutive patients received the same batch of 5000-centistoke silicone oil as endotamponade at the conclusion of vitreoretinal surgery and presented with features of acute intraocular inflammation, which was due to an infective cause. The infective organism isolated from the mixture of silicone oil and fluid was B. cepacia in three out of the initial cluster of four eyes and P. aeruginosa in the fifth eye.Outcome of managementThe initial 4 eyes evolved into eyes with poor vision (hand motion, perception of light and no perception of light), advanced proliferative vitreoretinopathy, hypotony, phthisis bulbi and cornea opacity. The poor visual outcome was deemed to be consequent to delay in removal of the silicone oil, despite use of intravitreal, systemic and topical antibiotics. The fifth case, because of the heightened index of suspicion gained from the preceding four cases, had a prompt removal of the silicone oil, vitreal lavage with antibiotics, and intravitreal injection of antibiotics and steroid. He regained a 6/9 vision.ConclusionGram-negative bacilli can colonize silicone oil resulting in post pars plana vitrectomy endophthalmitis. The index of suspicion for this should be high and can be managed successfully with prompt removal of the silicone oil, microbial sensitive antibiotic lavage of the vitreous cavity, followed by a repeat tamponade.

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Long-Lasting Endotamponades in Vitreoretinal Surgery

Cited by 21 publications

References 153 publications

Vitreous Substitutes: Old and New Materials in Vitreoretinal Surgery

Vitreous Substitutes: Old and New Materials in Vitreoretinal Surgery

Perfluorocarbon Liquid: Its Application in Vitreoretinal Surgery and Related Ocular Inflammation

Burkholderia cepacia, a cause of post pars plana vitrectomy silicone oil related endophthalmitis: clinico-pathological presentation and outcome of management

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