Silicone oil injection and removal in 27-gauge vitreous surgery

Kitagawa, Yorihisa; Yukita, Masayoshi; Naruse, Saigen

doi:10.18240/ijo.2023.01.21

“…The exclusion criteria were as follows: i) A history of previous PPV; and ii) eyes that had <6 months of follow-up after PPV. In addition, as the diameter of 27-G is smaller than 25-G, more time is needed to complete silicone oil tamponade with 27-G ( 22 ). The operating time of the two groups (25-G and 27-G) would therefore not be comparable if silicone oil injection is used.…”

Section: Methodsmentioning

confidence: 99%

27‑Gauge vitrectomy vs. 25‑gauge vitrectomy in the management of proliferative diabetic retinopathy with preoperative intravitreal injection of conbercept

Xiang,

Fang,

Jiang

et al. 2023

Exp Ther Med

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Small-gauge vitrectomy has become popular due to its notable advantages, including less trauma, shortened convalescence and improved manoeuvrability. The aim of the present study was to compare the surgical outcomes of 27-gauge (27-G) vitrectomy with those of 25-gauge (25-G) vitrectomy in the management of proliferative diabetic retinopathy (PDR) with preoperative intravitreal injection of conbercept. The data of 48 consecutive patients with PDR (48 eyes) were retrospectively collected. The patients underwent conbercept intravitreal injection and pars plana vitrectomy with a 27-G group (23 eyes) or 25-G group (25 eyes) vitrectomy system. The operating time, suturing rate, endodiathermy rate, postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP) and complications were recorded. The mean postoperative BCVA at final follow-up was significantly improved compared with that at the baseline in both groups (P<0.001 for both). The differences in the mean BCVA changes between the two groups were not significant (P>0.99), and no differences were observed in the final central foveal thickness (P=0.51) between the two groups. The final IOP remained stable compared with that at the baseline in the 27-G group (P=0.36) and the 25-G group (P=0.05). The suturing rate was significantly decreased in the 27-G group compared with the 25-G group (P=0.04). There were no significant differences between the two groups in terms of the operating time (P=0.18), rate of endodiathermy use (P>0.99), iatrogenic retinal breaks (P=0.42) or postoperative recurrent vitreous haemorrhage (P>0.99). In addition, no case of ocular hypotony was observed in either group. In conclusion, 27-G vitrectomy was as efficient and safe as 25-G vitrectomy in the management of PDR in terms of operating time and complications. With reference to the literature, preoperative conbercept injection appears to assist in decreasing the incidence of intraoperative and postoperative complications.

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“…It is well known that the emulsification and migration of silicone oil can cause many postoperative complications, including secondary glaucoma, corneal degeneration or decompensation [7,10,11], and even the introduction of silicone oil into the skull has been reported [12]. Many clinical studies have suggested that silicone oil should be removed approximately 3 to 6 months after vitrectomy [13][14][15][16]. The residual silicone oil droplets attached to the posterior lens capsule after silicone oil removal is one of the reasons to accelerate the opacity and affect the postoperative visual acuity [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Posterior capsular radial sign: a novel method to confirm anterior vitreous cortex resection in phacovitrectomy

Qu,

Zhou,

Shao

et al. 2024

BMC Ophthalmol

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Background The main purpose of this paper is to introduce a method that can accurately locate the posterior capsule of the lens to facilitate a relatively complete resection of the anterior vitreous body. Methods A total of 51 patients in the experimental group and control group were enrolled in this study. Phacoemulsification combined with vitrectomy was performed in all cases. After the cataract procedure was completed in the control group, the surgeon performed a conventional anterior vitrectomy with the operative eye. In the experimental group, anterior vitrectomy was performed according to the threadiness corrugation of the posterior capsule of the lens. During the operation, with the help of triamcinolone, two surgeons confirmed the resection of the anterior vitreous cortex; the best corrected visual acuity and intraocular pressure of all patients were recorded at 1 week, 1 month and 3 months after surgery. Results Fifty patients underwent phacoemulsification combined with vitrectomy, except one patient in the experimental group who was lost to follow-up. After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. There was no significant difference in preoperative visual acuity between the two groups (t = 0.83, P = 0.25). Both groups had varying degrees of improvement in best corrected visual acuity at 1 week, 1 month and 3 months after surgery. Moreover, there was no significant difference in BCVA between the two groups at the three follow-up time points (t=-1.15, -1.65, -1.09, P = 0.53, 0.21, 0.23). After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. Incomplete resection of the anterior vitreous cortex was observed in 2 patients in each group, but there was no significant difference (χ2 = 7.81, P > 0.05). Conclusion In the process of cataract surgery combined with vitrectomy, thready corrugation appears in the posterior capsule of the lens and is an important sign of its localization. Anterior vitrectomy can be accomplished safely and effectively with the help of thread-like corrugation, and the surgical effect is almost the same as that of traditional surgery. Especially suitable for beginners in vitreous surgery.

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“…It is well known that the emulsi cation and migration of silicone oil can cause many postoperative complications, including secondary glaucoma, corneal degeneration or decompensation [10][11][12], and even the introduction of silicone oil into the skull has been reported [13]. Many clinical studies have shown that silicone oil should be removed approximately 3 to 6 months after vitrectomy [14][15][16][17]. The residual silicone oil droplets attached to the posterior lens capsule after silicone oil extraction are the main reason to accelerate the opacity and affect the postoperative visual acuity [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Posterior Capsular Radial Sign: A Novel Method to Confirm Anterior Vitreous Cortex Resection in Phacovitrectomy

Qu,

Zhou,

Shao

et al. 2023

Preprint

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Background The main purpose of this paper is to introduce a method that can accurately locate the posterior capsule of the lens to facilitate a relatively complete resection of the anterior vitreous body. Methods A total of 51 patients in the experimental group and control group were enrolled in this study. Phacoemulsification combined with vitrectomy was performed in all cases. After the cataract procedure was completed in the control group, the surgeon performed a conventional anterior vitrectomy with the operative eye. In the experimental group, anterior vitrectomy was performed according to the threadiness corrugation of the posterior capsule of the lens. During the operation, with the help of triamcinolone, two surgeons confirmed the resection of the anterior vitreous cortex; the best corrected visual acuity and intraocular pressure of all patients were recorded at 1 week, 1 month and 3 months after surgery. Results Fifty patients underwent phacoemulsification combined with vitrectomy, except one patient in the experimental group who was lost to follow-up. After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. There was no significant difference in preoperative visual acuity between the two groups (t = 0.83, P = 0.25). Both groups had varying degrees of improvement in best corrected visual acuity at 1 week, 1 month and 3 months after surgery. Moreover, there was no significant difference in BCVA between the two groups at the three follow-up time points (t=-1.15, -1.65, -1.09, P = 0.53, 0.21, 0.23). After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. Incomplete resection of the anterior vitreous cortex was observed in 2 patients in each group, but there was no significant difference (χ2 = 7.81, P > 0.05). Conclusion In the process of cataract surgery combined with vitrectomy, thready corrugation appears in the posterior capsule of the lens and is an important sign of its localization. Anterior vitrectomy can be accomplished safely and effectively with the help of thread-like corrugation, and the surgical effect is almost the same as that of traditional surgery. Especially suitable for beginners in vitreous surgery.

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Silicone oil injection and removal in 27-gauge vitreous surgery

Cited by 4 publications

References 10 publications

27‑Gauge vitrectomy vs. 25‑gauge vitrectomy in the management of proliferative diabetic retinopathy with preoperative intravitreal injection of conbercept

27‑Gauge vitrectomy vs. 25‑gauge vitrectomy in the management of proliferative diabetic retinopathy with preoperative intravitreal injection of conbercept

Posterior capsular radial sign: a novel method to confirm anterior vitreous cortex resection in phacovitrectomy

Posterior Capsular Radial Sign: A Novel Method to Confirm Anterior Vitreous Cortex Resection in Phacovitrectomy

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