Primary silicone oil tamponade and internal limiting membrane peeling for retinal detachment due to macular hole in highly myopic eyes with chorioretinal atrophy

Abstract

BackgroundRetinal detachment (RD) secondary to macular hole (MH) is a common complication in highly myopic eyes, usually leading to a poor visual prognosis. The purpose of this study was to evaluate the surgical outcome of silicone oil (SO) tamponade and internal limiting membrane (ILM) peeling in the treatment of RD caused by MH (MHRD) in highly myopic eyes with chorioretinal atrophy, and to identify clinical factors associated with the anatomical outcomes.MethodsWe retrospectively reviewed 21 eyes of 21 highly myopic patients affected by RD secondary to MH and chorioretinal atrophy. All eyes were treated with pars plana vitrectomy (PPV) with ILM peeling and SO tamponade. Anatomical success was defined as reattachment of the retina with the closure of the MH, as assessed by optical coherence tomography (OCT), after SO removal. Logistic regression was performed to determine the clinical factors influencing anatomical success.ResultsThe mean patient age was 59.95 years [standard deviation (SD), 10.39; range, 34–77 years] and the mean axial length was 30.58 mm (SD, 1.52; range, 27.99–34.51 mm). After the first surgical procedure, the anatomical success rate was 61.9 % (13 eyes in 21 eyes), with initial retinal attachment of16 eyes (76.2 %). A second surgical approach was performed for the five eyes with persistent or recurrent RD, and the final retinal reattachment rate was 100 % (21/21). Logistic regression analysis showed that no specific factors were significantly associated with anatomical success.ConclusionsPrimary silicone oil tamponade and ILM peeling can be a practical treatment for repairing MHRD in highly myopic eyes with chorioretinal atrophy.

Long-Term Outcome After Silicone Oil Removal in Eyes with Myopic Retinal Detachment Associated with Macular Hole

“…The authors did not comment on the type of macular hole closure. Hong et al 9 reported 76.2% and 100% retinal re-attachment rates after primary and repeat surgeries, respectively. Macular hole closure rate was 61.9% after primary surgery and 76.2% after repeat surgery.…”

“…[2][3][4][5] Hence, several alternative techniques were introduced for MRDMH, though with no consensus to date among retina surgeons on one optimal surgical approach. [6][7][8][9][10][11][12] Some authors advocated that a longer term tamponade provided by silicone oil could improve the surgical outcome of MRDMH patients for several reasons. Firstly, silicone oil provides the desired tamponade effect while averting centrifugal overstretch of the inelastic retina around the hole.…”

Ranibizumab Pretreatment in Vitrectomy with Internal Limiting Membrane Peeling on Diabetic Macular Edema in Severe Proliferative Diabetic Retinopathy

“…Peeling away the ILM can not only relax the adhesions of the macula of the vitreous and completely relieve the traction of the posterior boundary membrane of the vitreous on the macula but also reduce the adhesion of VEGF, inflammatory factors and other related vasoactive factors and reduce the recurrence rate of vitreous macular interface disease. Consequently, PPV with ILM peeling has been applied in the surgical treatment of fundus diseases, especially in MHs, ME, macular epiretinal membranes, retinal splitting and other tractive macular diseases [9]. The need for combined ILM peeling in patients with DME, however, is currently controversial.…”

Rapid detection of bacterial endotoxins in ophthalmic viscosurgical device materials by direct analysis in real time mass spectrometry

“…Silikon 1000, in the form of silicone oil or polydimethylsiloxane, has been used as vitreous substitute to treat difficult cases of retinal detachment as well as medical devices for prosthetic and cosmetic purposes [43,44]. Silicone injection is believed to be theoretically inert for decades but now is thought to be a potential cause for direct and indirect toxic effects in biological system [52–54].…”

“…When the DART source is coupled to different mass spectrometers, it provides a rapid MS analysis of a wide range of compounds [35–39], where its mechanism and applications are described elsewhere and summarized in a couple of reviewpapers [33,34]. In this study DART-MS is introduced for the first time to measure the presence of bacterial endotoxin in OVD materials, including sodium hyaluronate (NaHA) [40], perfluoro- n -octane (PFO) [41,42], and silicone oil (SO) [43,44]. Sodium hyaluronate is currently the most popular viscoelastic injection for a variety of intraocular surgical procedures such as cataract extraction, lens implantation and retina attachments since the 1970s.…”