Purchase this article with an account.
Svenja Deuchler, Pankaj Singh, Michael Mueller, Thomas Kohnen, Frank HJ Koch; Peri- and intraoperative factors affecting the emulsification of silicone oil used for retinal re-attachment in complicated retinal detachments. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2319.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to compare the grade of emulsification in patients carrying silicone oil tamponade in regard to viscosity of the oil and peri- and intraoperative factors.
After silicone oil removal, severity of emulsification was measured and the results were compared to various patient-specific factors to point out the critical ones. The study contained 19 patients and silicone oils with a viscosity of 5,000, 4,300 and 2,000 mPas were considered. For determination, oil samples were placed immediately after SO removal on a silanized stage. A second thinner stage was placed in a distance of 0.25 mm to create a chamber with a defined height/volume. The bubbles caused by emulsification were counted and an image was taken. A software determined size and number of the bubbles per square centimeter. The results were categorized and evaluated.
The evaluation showed no significant gain of emulsification through the different viscosities or gender. There was no coherence between emulsification and forgone cataract-surgery or silicone oil usage. However, a higher emulsification rate was detected if silicone oil was implanted after using PFC ( 1,8 times higher) and when laser was applied not before but after silicone oil installation (2,0 time higher). Diseases such as diabetes or HIV boosted the emulsification of silicone oil.
This study offers an easy and convenient method to evaluate emulsification in silicone oil tamponade and shows how peri- and intraoperative factors of a patient influence the emulsification.The silicone oils themselves seem to have very little if at all influence on the severity of emulsification. High-level emulsifications after silicone fill and consecutive laser treatments were to be expected. Also it was to be expected that diseases like HIV cause serious emulsifications because of a battered immune system. However, the surgeon and his technique during entering and removal of the silicone oil is a factor which is difficult to measure. A difficult removal of the silicone oil can cause small bubbles which are not caused by the human body but nevertheless counted by the software. Based on the results of this study the counting method and the evaluation-process are going to be optimized for more consistent results.
This PDF is available to Subscribers Only