Objective To evaluate the efficacy and its affecting factors of silicone oil as an introocular tamponade for copmlicated retinal detachments in children(le;14 years). Methods We analysed retrospectively 34 cases(36 eyes) of complicated retinal detachments in children, who were performed with pars plana vitrectomy combined with silicone oil tamponade from June 1993 to November 1997. Results After 3-21 months of follow-up, the detached retinas in 19 eyes(52.7%) were reattached, in 10 eyes(27.8%) partially reattached and in 6 eyes (16.7%) redetached, 1 eye(2.8) had a media opacity that precluded evaluation of the retina. Postoperative visual acuity was less than 0.05 in 12 eyes(33.3%), and 0.05-0.2 in 20 eyes(55.6%), 2 cases(4 eyes) could not tell their visions(11.1%). Conclusion Silicone oil tamponade is an effctive therapy for complicated retinal detachments in children. The major cause of surgical fai;ure was development of recurrent proliferative vetrioretinopathy. (Chin J Ocul Fundus Dis,1999,15:7-8)
Objective To investigate the characteristics of ultrasonogram of eyes with silicon oil tamponade. Methods Forty-seven patients (47 eyes) who had undergone the operation of silicon-oil removing were examined by A-(to determine the length of ocular axis) and B-scan before and after the operation respectively. The length of ocular axis and cubage of vitreous chamber were detected and the characteristics of the ultrasonograms were observed according to the default parameters of ultrasonograph. Results The results of A-scan showed that the preoperative axial length was 1.465 times of the postoperative one in the eyes without lens, and 1.284 times in eyes with lens; after modified the parameter according to the acoustic velocity, the preoperative axial length was (0.78±0.34) mm longer than the postoperative one in the eyes without lens, and (0.56±0.32) mm in eyes with lens. The results of A-scan showed that the cubage of vitreous chamber enlarged obviously in eyes with silicon oil tamponade, and the acoustic features included complete filling and partial filling according to the amount of silicon oil. Several arc echoes at the posterior segment of eye were detected in the silicon-oil-filling eyes with retinal detachment. Conclusion In the silicon-oil-filling eyes with lengthened ocular axis, the characteristics of B-scan images are affected by acoustic velocity through silicon oil, the amount of silicon oil capacity and the emulsification of silicon oil. (Chin J Ocul Fundus Dis，2004，20：349-351)
Objective To observe the therapeutic effect of combined surgery of anterior and posterior segment and silicon oil tamponade on macular hole retinal detachment in eyes with high myopia.Methods The clinical data of 48 high myopia patients (48 eyes) with macular hole retinal detachment were retrospectively analyzed. Retinal detachment was mainly at the posterior pole; macular hole was confirmed by noncontact Hruby lens and optical coherence tomography (OCT). Phacoemulsification combined with pars plana vitrectomy and silicon oil tamponade were performed to all patients, of which 41 had undergone internal limiting membrane peeling, and 23 had intraocular lens implanting. The oil had been removed 3.5-48.0 months after the first surgery and OCT had been performed before the removal. The followup period after the removal of the silicon oil was more than 1 year.Results The edge of the macular hole could not be seen under the noncontact Hruby lens 1 week after the surgery in all but 5 patients, and the visual acuity improved. The silicon oil had been removed in all of the 48 patients; the OCT scan before the removal showed that the closed macular holes can be in U shape (8 eyes), V shape (6 eyes) or W shape (23 eyes). About 1338 months after the oil removal, retinal detachment recurred in 2 patients with the Wshaped holes. At the end of the followup period, 16 patients (33.3%) had U or Vshaped macular holes, and 32 patients (66.7%) had Wshaped macular holes. The rate of retinal reattachment was 100%.Conclusion Combined surgery of anterior and posterior segment and silicon oil tamponade is effective on macular hole retinal detachment in eyes with high myopia.
PURPOSE:To evaluate the ability Of retinoic acid(RA) in silicon oil(SiO)to inhibit the proliferation of injected intraocular fibroblast cells. METHODS:Thirty New Zealand white rabbits (58 eyes)were divided into three groups. In control group ,only SiO(10 eyes)or BSS(10 eyes)were injected intravitreally and 5mu;g/ml (18 eyes)or 10mu;g/ml (20 eyes)RA in SiO were injected into other lwo groups respectively. Three days after gas-compression vitrectomy, 2 times;105 fibroblasts and Sio(0.5ml)or BSS(0.5ml)were injected in all eyes sequentially.The morbidity of tractional retinal detachment (TRD) were observed by ophthalmoscope until 4 weeks. RESULTS:After 4 weeks,in control ,5mu;g/ml RA in SiO and 10mu;g/ml RA in SiO group,80. 00%,44.44%,and 30.00% eyes developed TRD respectively. Significant statistical differences were found between the control group and the two treated groups (P＜0.05). CONCLUSIONS:5mu;g/ml or 10mu;g/ml RA in SiO can inhibit the occurrence of TRD effectively. （Chin J Ocul Fundus Dis,1997,13:174-176）
ObjectiveTo evaluate the incidence of retinal re-detachment and possible risk factors after removal of silicone oil. MethodsThe clinical data of 821 patients (858 eyes) who underwent removal of silicone oil in General Hospital of PLA during 2008-2012 were retrospectively analyzed. The patients included 518 males and 303 females. The age was ranged from 1 to 79 years old, with an average of 44.03 years. All patients underwent removal of silicone oil after vitrectomy combined with silicone oil tamponade (the tamponade period was ranged from 40 days to 13 years, with an average of 6.82 months). The incidence, time and causes of retinal re-detachment were analyzed. ResultsRetinal re-detachment occurred in 43 patients (44 eyes, 5.13%). Among these retinal re-detachment in 44 eyes, 23 eyes (52.27%) occurred in 1 week, 13 eyes (29.55%) in 1-4 weeks, 4 eyes (9.08%) in 4-8 weeks, 2 eyes (4.55%) in 8-12 weeks, and 2 eyes (4.55%) more than 12 weeks after silicone oil removal. Possible reasons of retinal re-detachment included activated original retinal holes (7 eyes), residual peripheral vitreous (3 eyes), traction of epiretinal proliferative membrane (18 eyes), new retinal hole (9 eyes), non-closure of original retinal holes (5 eyes) and traction of retinal incarceration in the scleral incision (2 eyes). ConclusionsThe incidence of retinal re-detachment after silicone oil removal is 5.13%. The incidence reduced gradually with the extension of time after removal silicone oil.
ObjectiveTo investigate the potential effect of hyperopia status on subfoveal choroidal thickness (SFCT) in silicone oil (SO)-filled eyes.MethodsThis self-comparative study was conducted in Department of Ophthalmology, Central Theater Command General Hospital. The 50 patients (100 eyes) were collected with unilateral macula-on rhegmatogenous retinal detachment from January 2019 to July 2019, who successfully underwent pars plana vitrectomy (PPV) and SO tamponade. Retinal reattachment was observed after surgery in all patients. One month after PPV, the affected eye was wore soft, contact lenses for 24 hours to correct refractive error (RE), depending on its optometry value. The SFCT of the affected eyes was measured using OCT before and after lenses wear. The fellow eyes also received OCT examination at the same time. T test was used to compare SFCT between SO-filled eyes and fellow eyes.ResultsThe mean RE of the SO-filled eyes was +6.38±1.12 D. The mean SFCT of SO-filled eyes (247.12±17.63 μm) was significantly thinner than that of the fellow eyes (276.32.55±17.63 μm) (P＜0.001). The SFCT of the SO-filled eyes was significantly thinner than fellow eyes, and the difference was statistically significant (t=－3.95, P＜0.001). After lenses wear, the mean SFCT of the SO-filled eyes increased to 276.32±24.86 μm. Compared with before lenses wear, the difference was statistically significant (t=－4.30, P＜0.001). Compared with the fellow eye, the difference was not statistically significant (t=0.05, P＞0.05).ConclusionSFCT reduction in the SO-filled eyes may be due to the hyperopia status caused by SO, which can be reserved by RE correction.
Objective To evaluate the long-term results of vitreoretinal surgery without use of intraocular silicone oil or gas in patients with diabetic tractional retinal detachment (DTRD). Methods The clinical interventional caseseries study included 104 patients (112 eyes) with DTRD, who were consecutively treated by pars plana vitrectomy without use of intraocular silicone oil or gas. Among the eyes, there were 6 eyes with iris neovascularization (INV), 1 eye with neovascular glaucoma (NVG) and 50 eyes with macular retinal detachment. There were no preexisting retinal holes or breaks prior to surgery nor any iatrogenic retinal breaks developed during vitrectomy. Cataract removal combined with intraocular lens implant surgeries were performed on 15 eyes. Followup duration varied from 12 to 65 months (mean: 29 months). Results Subretinal fluid was completely absorbed within 2 months after surgery. In 107 eyes (95.54%), the retina reattached after surgery and remained attached till the end of followup period. Best corrected visual acuity (BCVA) improved in 79 eyes (70.53%), remained unchanged in 14 eyes (12.50%) and got worse in 19 eyes (16.79%). The BCVA improving rate was lower in the macular detached group (33 eyes/50 eyes, 66.00% Vs 46 eyes/62 eyes, 74.19%,chi;2=0.89, P=0.344). No obviously aggravated opacity of lens was observed after vitreoretinal surgeries in the eyes without cataract surgeries. Seven (6.25%) eyes showed INV (5 new onset eyes), and none of them developed into NVG. In multivariate logistic regression, factors associated with postoperative rubeosis iridis were pre-existing rubeosis iridis ［adjusted odds ratio (OR)=10.2］, low preoperative BCVA (OR=11.1) and low postoperative BCVA (OR=16.7). Conclusions Vitreoretinal surgery for DTRD may not necessarily be combined with silicone oilor gas tamponade if there are no preoperative or intraoperative retinal breaks, and only using irrigation fluid could access a good longterm prognosis result.
Objective To evaluate the relative factors of effect of vitrectomy on corneal endothelial cells. Methods Retrospective analysis of the results of corneal endothelium microscopy performed on 213 eyes of 213 patients undergone vetrectomy operations including single vitrectomy (78 eyes), vitrectomy combined with cataract extraction (135 eyes), silicone oil injection (34 eyes), and C3F8 injection (53 eyes) before and after 1 week, 1 and 3 moths of these surgical procedures. Results There was no significant difference between pre- and postoperative corneal endothelium density in single vitrectomy group and vitrectomy combined with cataract extraction with posterior capsule integrity group (Pgt;0.05). The corneal endothelium density significantly decreased postoperatively in C3F8or silicone oil injection group with broken posterior capsule (Plt;0.05). Conclusion C3F8 and silicone oil may damnify corneal endothelium in patients undergo vitrectom y combined with cataract extraction with broken posterior capsule. (Chin J Ocul Fundus Dis，2004，20：101-103)
Objective To investigate the time and the mechanism of the toxic and side effects of silicone oil on ocular tissues. Methods 19 human eyeballs were examined histopathologically at different time intervals after silicone oil tamponade. Results Microscopic bubbles presumably containing silicone oil were found in sensory retina,RPE,optic nerve, pre and subretinal membrane,iris,anterior chamber angle,and retrocorneal membrane.In the eyes containing silicone oil for less than 9 months.Silicone bubbles were present only in the surface of retina(within preretinal membrane or macrophages),and after that time,silicone bubbles were noted within sensory retina.In an eye enucleated 39 months after intravitreal silicone tamponade,the parenchyma and subarachnoid space of the optic nerve were found to be diffusely invaded by silicone bubbles. Conclusion The histopathologic changes of ocular tissues are related to the duration of intravitreal silicone oil tamponade. (Chin J Ocul Fundus Dis, 1999, 15: 232-234)
Objective To evaluate the effect of vitreoretinal surgery with lens-sparing technique in treating the detachment with giant retinal tear(GRT) associated with proliferative vitreoretinopathy(PVR). Methods Thirty-one consecutive eyes with GRT unde rwent vitrectomy were analysed retrospectively. Operative techniques included peeling of pre-retinal membrane， injection of perfluorodecalin liquid， retinotomy and retinectomy，endolaser，and silicon oil or C2F6 gas tamponade. Lens-sparing vitrectomy was performed in 28 phakic eyes. Follow-up period ranged from 11 to 34 months. Results Anatomic retina l attachment was achieved intraoeratively in 29 eyes. In 16 eyes of 28 eyes with postoperative cataract formation,3 eyes underwent cataract surgery with or without intraocular lens implantation. The corrected final visual acuity ran ged from 0.4 to 0.01. Conclusion Most phakic eyes of retinal detachment with GRT PVR can be successfully operated on with an out come of improving the visual acuity by using techniques of lens-sparing vitrectomy, perfluorodecalin liquid and silcone oil tamponade. (Chin J Ocul Fundus Dis, 2001,17:93-95)