Clinical observation of silicone oil removal via three-channel 23-gauge incision

Abstract

Objective To compare the clinical effects and surgical complications of silicone oil removal via the three-channel 23-gauge(23G)incision with the two-channel 20-gauge(20G)incision.Methods Patients who underwent silicone oil removal from January 2012 to December 2012 were included in this study.They were randomly divided into two groups.In group A,three-channel 23G incisions was used.The perfusion tube was placed in the inferior temporal eyeball,and the vitrectomy machine was connected to the superior incision by the infusion tube.The silicone oil was removed via this superior incision and for gas-liquid exchange twice hereafter.As for group B,two-channel 20G incisions were adopted.An inferior temporal pars plana irrigation was placed,silicone oil was extracted from the superior corneal tunnel incision in aphakic eyes,and from pars plana incision in phakic eye.Results The average operative time was 38.41±10.32min and 36.57±9.88min in group A and group B respectively,no statistically significant difference(t =1.089,P ＞0.05).In group A,the visual acuity was improved in 43 eyes,unchanged in 20 eyes,decreased in 7 eyes.In group B,the visual acuity was improved in 40 eyes,unchanged in 23 eyes,decreased in 9 eyes.No significant difference between the two groups(x2=0.540,P ＞0.05).The duration of postoperative discomfort in group A and group B was 7.33±3.05 days and 17.68±3.51 days respectively.The difference was statistically significant(t =18.747,P =0.00).The postoperative silicone oil residue occurred in 0 case in group A,and 6 cases in group B (z =-2.459,P ＜0.05).SuprachoroidaI hemorrhage occurred in one eye in group A,and 0 in group B(z =-1.014,P ＞0.05).Retinal redetachment emerged in 3 eyes in group A,and 10 eyes in group B(x2=3.936,P ＜0.05).Higher intraocular pressure in group A and group B was 3 eyes and 8 eyes respectively(z =-1.516,P ＞0.05),lower intraocular pressure in each group was 5 eyes.Cornea condition was improved in 10 eyes,unchanged in 55 eyes,worsen in 5 eyes in group A; as in group B the number was 9,56 and 7(x2=0.367,P ＞0.05).Conclusions The procedure with the three-channel 23G incision is simple and the membrane can be peeled.The 23G procedure has lower rate of retinal redetachment,fewer silicone oil residue,more comfortable postoperative feeling,and the same operative time.In conclusion,silicone oil removal via 23G has certain clinical application value. Key words: Silicone oil removal; 23G incision; Three channels; Clinical observation