Passive removal of silicone oil through 23 gauge transconjunctival sutureless vitrectomy system

Nisar Ahmed Siyal ,Lakhani Das Hargun,Shahid Wahab

doi:10.12669/pjms.323.9498

Abstract

Objective:To study the outcomes of passive removal of silicone oil by 23 Gauge Transconjunctival Sutureless Vitrectomy System.Methods:This prospective, consecutive case series study was conducted at Ophthalmology Department Unit I, Dow University of Health Sciences, Civil Hospital Karachi from January 2011 to December 2014. Only psuedophakic eyes with silicone oil temponade were selected. Main outcome measures were intra ocular pressure, time taken for removal of silicone oil, per operative and post operative complications. Pre and post operative IOP was compared by using two-tailed paired t-test and mean values with standard deviation were computed using difference of 95% confidence interval. Chi square test was applied for correlation of different variables. P-value of less than 0.05 was considered statistically significant.Results:Out of 79 patients who underwent passive ROSO, 38 (48.1%) were males. Mean age of patients was 47.5±7.1 (sd) years. Mean time taken for passive ROSO was 7.31±2.41 (sd) minutes. Pre and post operative intra ocular pressure shows statistically significant (p=0.000) decrease in IOP. Retinal redetachment found in 13 (16.5%) cases during follow up period.Conclusion:Passive removal of silicone oil with 23 G suture less vitrectomy system is safe and effective in terms of less per operative and post operative complications. In this simple technique, there is less tissue trauma and little time consumed so it provides more comfort to patients and surgeons as well.

Highlights

Silicone oil is a liquid with unique properties of surface tension. It had been widely used as long term internal temponading agent during retinal re attachment surgery by vitreo retinal (VR) surgeons for the last almost six decades.[1]
To the best of our knowledge no such study has been conducted in our setup so we studied the efficacy and safety of 23 Gauge transconjunctival sutureless vitrectomy systems (TSVS) in terms of per operative and post operative difficulties and complications
Eyes with corneal pathology or having any other retinopathy were 23 gauge transconjunctival sutureless vitrectomy excluded from this series

Summary

Introduction

Silicone oil is a liquid with unique properties of surface tension. It had been widely used as long term internal temponading agent during retinal re attachment surgery by vitreo retinal (VR) surgeons for the last almost six decades.[1] silicone oil in long term can be toxic to photoreceptors[2] and cause other complications such as cataract, secondary glaucoma and keratopathy as well.[3,4] removal of silicone oil (ROSO) becomes essential in several cases and even some surgeons recommend it in almost all cases with few exceptions. ROSO carries risk of retinal re-datachment and some other complications but all VR specialist agreed that once the objectives of temponade is achieved and retina become stable, silicone oil should be removed

Methods

Results

Conclusion