AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a re...AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a retrospective, non-randomized controlled study. We performed SOR with 23-gauge infusion and 20-gauge active suction technique on 29 patients 29 eyes from April to October, 2011 (mixed group). During the surgeries, a 23-gauge sclerotomy was made for infusion and a 20-gauge sclerotomy was used for active silicone oil suction. Anterior segment optical coherence tomography (OCT) was applied for 23-gauge sclerotomy analysis 1 day post-operation. Traditional 20-gauge SOR was performed on another consecutive 29 patients 29 eyes, the control group (20G group). RESULTS: There were 2 eyes (6.9%) in mixed group and 5 eyes (17.2%) in 20G group which had recurrent retinal detachment after surgery. Hopytony (IOP <= 6mmHg) occurred in 8 eyes (27.6%) of mixed group and in 10 eyes (34.5%) of 20G group post-operation, but all of them recovered to the normal level finally. There were no statistical significant differences. Final visual acuity was significantly increased after surgery in both groups. Anterior segment OCT images were acquired from 13 eyes of mixed group, and all of them had a proper wound apposition. But local ciliary detachment was found in 9 eyes (69%). It was hard to define the OCT image of the sclerotomies and ciliary body because of the serious conjunctival hemorrhages and chemosis in 20G group. CONCLUSION: This mixed technique is a convenient and effective way to remove high viscosity silicone oil. Compared with traditional 20-gauge SOR, it does not increase the risk of post-operative complications and has less conjunctival reactions.. Transient postoperative hypotony is common for this procedure and subclinical ciliochoroidal detachment is a probable cause.展开更多
·AIM: To report on the outcome of Ahmed glaucoma valve (AGV) implantation for the management of neovascular glaucoma (NVG) after 23 -gauge vitrectomy for proliferative diabetic retinopathy (PDR). ·METHODS: T...·AIM: To report on the outcome of Ahmed glaucoma valve (AGV) implantation for the management of neovascular glaucoma (NVG) after 23 -gauge vitrectomy for proliferative diabetic retinopathy (PDR). ·METHODS: Twelve medically uncontrolled NVG with earlier 23 -gauge vitrectomy for PDR underwent AGV implantation. The control of intraocular pressure (IOP), preoperative and postoperative best -corrected visual acuity, the development of intraoperative and postoperative complications were evaluated during the follow-up. ·RESULTS: The mean follow-up was 15.4±4.3 months (9-23 months). Mean preoperative IOP was 49.4±5.1mmHg and mean postoperative IOP at the last visit was 17.5 ± 1.6mmHg. The control of IOP was achieved at the final follow -up visits in all patients, however, 8 of 12 patients still needed anti-glaucoma medication (mean number of medications, 0.8±0.7). The visual acuity improved in nine eyes, and the visual acuity unchanged in three eyes at the final follow -up visits. The complications that occurred were minor hyphema in three eyes, choroid detachment in two eyes, and the minor hyphema and choroid detachments were reabsorbed without any surgical intervention. ·CONCLUSION: AGV implantation is a safe and effective procedure that enables successful IOP control and vision preservation in the NVG patients with the history of earlier 23-gauge vitrectomy for PDR.·展开更多
AIM：To report a simple approach to actively remove high viscosity silicone oil through a 23-gauge cannula via pars plana.METHODS：Forty-eight eyes of 48 patients underwent silicone oil（5700 centistokes） removal（SO...AIM：To report a simple approach to actively remove high viscosity silicone oil through a 23-gauge cannula via pars plana.METHODS：Forty-eight eyes of 48 patients underwent silicone oil（5700 centistokes） removal（SOR） were enrolled.A section of blood transfusion set was prepared to connect a standard 23-gauge cannula and vitrectomy machine.Silicone oil was removed with suction of500-mm Hg vacuum through the cannula.Main outcome measures were SOR duration,number of sutured sites,intraocular pressure（IOP）,best-corrected visual acuity（BCVA）,and complications.RESULTS：Silicone oil was successfully removed in all cases.The mean SOR time was 5.70±0.85 min.Nine eyes（18.75%） needed suture partial sclerotomies.No intraoperative complications were noted.Transient hypotony（≤8 mm Hg） was seen in 3 eyes（6.25%） on postoperative day 1,but all resolved within 1wk.Retinal reattachment was achieved in all cases and no other postoperative complications were noted during 3-month following-up.BCVA at the final visit improved or stabilized in all patients comparing to the preoperative level.CONCLUSION：Active removal of high viscosity silicone oil through a 23-gauge instrument cannula jointed with blood transfusion set is a practical and reliable technique when considering two sides of efficacy and safety.展开更多
文摘AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a retrospective, non-randomized controlled study. We performed SOR with 23-gauge infusion and 20-gauge active suction technique on 29 patients 29 eyes from April to October, 2011 (mixed group). During the surgeries, a 23-gauge sclerotomy was made for infusion and a 20-gauge sclerotomy was used for active silicone oil suction. Anterior segment optical coherence tomography (OCT) was applied for 23-gauge sclerotomy analysis 1 day post-operation. Traditional 20-gauge SOR was performed on another consecutive 29 patients 29 eyes, the control group (20G group). RESULTS: There were 2 eyes (6.9%) in mixed group and 5 eyes (17.2%) in 20G group which had recurrent retinal detachment after surgery. Hopytony (IOP <= 6mmHg) occurred in 8 eyes (27.6%) of mixed group and in 10 eyes (34.5%) of 20G group post-operation, but all of them recovered to the normal level finally. There were no statistical significant differences. Final visual acuity was significantly increased after surgery in both groups. Anterior segment OCT images were acquired from 13 eyes of mixed group, and all of them had a proper wound apposition. But local ciliary detachment was found in 9 eyes (69%). It was hard to define the OCT image of the sclerotomies and ciliary body because of the serious conjunctival hemorrhages and chemosis in 20G group. CONCLUSION: This mixed technique is a convenient and effective way to remove high viscosity silicone oil. Compared with traditional 20-gauge SOR, it does not increase the risk of post-operative complications and has less conjunctival reactions.. Transient postoperative hypotony is common for this procedure and subclinical ciliochoroidal detachment is a probable cause.
基金Shanghai Leading Academic Discipline Project, China (No.S30205)
文摘·AIM: To report on the outcome of Ahmed glaucoma valve (AGV) implantation for the management of neovascular glaucoma (NVG) after 23 -gauge vitrectomy for proliferative diabetic retinopathy (PDR). ·METHODS: Twelve medically uncontrolled NVG with earlier 23 -gauge vitrectomy for PDR underwent AGV implantation. The control of intraocular pressure (IOP), preoperative and postoperative best -corrected visual acuity, the development of intraoperative and postoperative complications were evaluated during the follow-up. ·RESULTS: The mean follow-up was 15.4±4.3 months (9-23 months). Mean preoperative IOP was 49.4±5.1mmHg and mean postoperative IOP at the last visit was 17.5 ± 1.6mmHg. The control of IOP was achieved at the final follow -up visits in all patients, however, 8 of 12 patients still needed anti-glaucoma medication (mean number of medications, 0.8±0.7). The visual acuity improved in nine eyes, and the visual acuity unchanged in three eyes at the final follow -up visits. The complications that occurred were minor hyphema in three eyes, choroid detachment in two eyes, and the minor hyphema and choroid detachments were reabsorbed without any surgical intervention. ·CONCLUSION: AGV implantation is a safe and effective procedure that enables successful IOP control and vision preservation in the NVG patients with the history of earlier 23-gauge vitrectomy for PDR.·
基金Supported by the National Nature Science Foundation(No.81473295)Science Technology project of Zhejiang Province(No.2014C33260)Wenzhou Science and Technology Bureau(No.Y20140142)
文摘AIM：To report a simple approach to actively remove high viscosity silicone oil through a 23-gauge cannula via pars plana.METHODS：Forty-eight eyes of 48 patients underwent silicone oil（5700 centistokes） removal（SOR） were enrolled.A section of blood transfusion set was prepared to connect a standard 23-gauge cannula and vitrectomy machine.Silicone oil was removed with suction of500-mm Hg vacuum through the cannula.Main outcome measures were SOR duration,number of sutured sites,intraocular pressure（IOP）,best-corrected visual acuity（BCVA）,and complications.RESULTS：Silicone oil was successfully removed in all cases.The mean SOR time was 5.70±0.85 min.Nine eyes（18.75%） needed suture partial sclerotomies.No intraoperative complications were noted.Transient hypotony（≤8 mm Hg） was seen in 3 eyes（6.25%） on postoperative day 1,but all resolved within 1wk.Retinal reattachment was achieved in all cases and no other postoperative complications were noted during 3-month following-up.BCVA at the final visit improved or stabilized in all patients comparing to the preoperative level.CONCLUSION：Active removal of high viscosity silicone oil through a 23-gauge instrument cannula jointed with blood transfusion set is a practical and reliable technique when considering two sides of efficacy and safety.
