Removal of silicone oil following diabetic vitrectomy.

Pearson, R V; McLeod, David; Gregor, Zdeněk

doi:10.1136/bjo.77.4.204

Cited by 35 publications

(21 citation statements)

References 19 publications

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“…Disadvantages include the certainty of cataract formation and the fact that at some point, the oil must be removed if visual rehabilitation is to be accomplished (Thompson et al 1986). Pearson and colleagues (1993) studied the effect of silicone oil removal following diabetic vitrectomy and concluded that the eventual final visual outcome in these eyes was encouraging in that once cataract and oil were removed; most eyes recovered the acuity achieved soon after initial vitrectomy.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy

El-Batarny¹

2009

OPTH

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PurposeTo evaluate the effect of intravitreal injection of Avastin, bevacizumab (IVA) on diabetic vitrectomy and on the postoperative course.MethodsThirty patients undergoing diabetic vitrectomy were distributed to standard vitrectomy (group 1) or vitrectomy with preoperative IVA (group 2). Bevacizumab was injected 5 to 7 days before surgery. Patients of both groups were matched as much as possible according to surgical indication and preoperative visual acuity. Main outcome measures were the feasibility of surgery and the postoperative complications. Feasibility of surgery was evaluated through recording surgical time, intraoperative bleeding, use of endodiathermy, relaxing retinotomies, use of perfluorocarbon liquid (PFCL) and silicone oil tamponade.ResultsFollow up ranged between 7 and 18 months. There was significant reduction of mean surgical time, bleeding frequency, and diathermy use in group 2 compared to group 1. The rate of PFCL use and relaxing retinotomies were less in group 2 in comparison to group 1. Gas or air was used in 80% of patients in group 2 while silicone oil represented 60% of group 1. Postoperative visual acuity improvement was highly significant in both groups but the difference in both groups was not statistically significant. Vision improved in 87% in group 2 and 80% in group 1. Primary anatomical attachment was achieved in 90.3% in group 2 and 86.6% in group 1. Rate of subsequent surgeries and persistent cataract were higher in group 1. Postoperative bleeding was reported in 26.6% of cases in group 1 and none in group 2. In group 2, no complications related to avastin injection or progression of traction were reported during the preoperative period.ConclusionPreoperative IVA was helpful in achieving the surgical and anatomical goals by reducing the time of surgery, the intraoperative and postoperative bleeding, and the use of silicone oil with subsequent reduction of second surgery.

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Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy

El-Batarny¹

2009

OPTH

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“…This is not always desirable because of the risk of redetachment which has been reported in up to one in three patients 9 particularly those with complex previous vitreoretinal pathology. 14 Glaucoma surgery on these difficult cases is often unsuccessful due to pre-existing conjunctival scarring following vitreoretinal procedures. 4 Glaucoma drainage implants offer an alternative surgical option but oil migration can occur through the tube into the subconjunctival space inciting an inflammatory reaction.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of the management of silicone oil-induced raised intraocular pressure by diode laser cycloablation

Ghazi-Nouri

Vakalis

Bloom

et al. 2004

Eye

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Aims/background To analyse the effectiveness and safety of cyclodiode treatment in eyes with silicone oil-related raised intraocular pressure (IOP) and to correlate the results with clinical features of treated eyes. Methods Retrospective review of case notes of all eyes that underwent cyclodiode treatment following injection of silicone oil at Moorfields Eye Hospital between April 1993 and January 2003 and were followed up for at least 1 year. Results In all, 38 patients were followed up for between 13 and 113 months. Totally, 17 had silicone oil in situ at the time of first treatment. The mean pretreatment IOP was 31.4 mmHg (SD 10.9), reducing to 18.6 mmHg (SD 8.6) at 1 year and to 13.9 mmHg (SD 8.4) at the final follow-up visit (Po0.001). Before treatment, 28 (73.7%) patients were on two or more topical medications. This was reduced to 18 (47.4%) patients (P ¼ 0.013) at 1 year and 13 (34.2%) patients (P ¼ 0.0007) at final follow-up. Use of oral acetazolamide for glaucoma was reduced from 16 (42.1%) patients precyclodiode to five (13.2%) patients at 1 year (P ¼ 0.0034) and three (7.9%) patients at the final visit (P ¼ 0.001). Four patients (10.5%) at 1 year and five patients (13.2%) at the final visit had hypotony (defined as IOP of less than 5 mmHg). One patient had enucleation 75 months following first cyclodiode treatment. Conclusion Diode laser photocoagulation can successfully control silicone oil-induced raised intraocular pressure where medical treatment fails. Reduction of IOP appears to be maintained long term.

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“…Retinal redetachment has been reported up in to 33% of patients1 10 and Casswell and Gregor1reported it as the most common major complication after the removal of oil. Retinal redetachment in diabetic eyes could be more serious because it is frequently associated with intractable rubeosis iridis 10…”

Section: Discussionmentioning

confidence: 99%

Effect of diode laser trans-scleral cyclophotocoagulation in the management of glaucoma after intravitreal silicone oil injection for complicated retinal detachments

Han

Park

Kim

et al. 1999

British Journal of Ophthalmology

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Aims-To evaluate the eVect of trans scleral cyclophotocoagulation (TSCPC) on intraocular pressure (IOP) in the eyes retaining intravitreal silicone oil with medically uncontrolled secondary glaucoma following intravitreal silicone oil injection. Methods-Medical records of 11 eyes of 11 patients who underwent TSCPC for medically uncontrolled glaucoma without pupillary block following intravitreal silicone oil injection for complicated retinal detachment were reviewed retrospectively. In all cases, intravitreal silicone oil was not removed for fear of retinal redetachment. Diode laser contact TSCPC was performed at a power of 1.5-2.5 W, for a duration of 2 seconds, and with 20-27 applications. IOP, number of glaucoma medications, and success rate were evaluated. Results-After a mean follow up period of 52.5 (SD 8.2) (range 42-68) weeks, the mean pretreatment level of IOP, 43.0 (14.4) (26-67) mmHg, had fallen to 14.5 (4.3) (7-20) mm Hg (p=0.003). The number of glaucoma medications was reduced from 2.6 (0.8) to 0.6 (1.0) (p= 0.005). Qualified success was achieved in nine eyes (81.8%) and complete success in six (54.5%). After TSCPC, patients' retinal status had not changed. Conclusion-Patients with medically uncontrolled glaucoma secondary to intravitreal silicone oil injection can be treated with TSCPC in spite of the retained intravitreal silicone oil. (Br J Ophthalmol 1999;83:713-717)

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Removal of silicone oil following diabetic vitrectomy.

Cited by 35 publications

References 19 publications

Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy

Intravitreal bevacizumab as an adjunctive therapy before diabetic vitrectomy

Long-term results of the management of silicone oil-induced raised intraocular pressure by diode laser cycloablation

Effect of diode laser trans-scleral cyclophotocoagulation in the management of glaucoma after intravitreal silicone oil injection for complicated retinal detachments

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