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Svenja Deuchler, Pankaj Singh, Michael Mueller, Thomas Kohnen, Hanns Ackermann, Joerg Iwanczuk, Rachid Benjilali, Frank H J Koch; Interaction between lens transparency loss and retinal reattachment surgery with preliminary silicone oil fill. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1078.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the impact of silicone oil tamponade (SOT) onto lens status and outcome of vitreoretinal surgery in retinal detachments with Proliferative VitreoRetinopathy (PVR).
101 eyes were analyzed retro- and 103 eyes prospectively with regard to retinal re-attachment rate and key factors for the outcome. In 27 out of 62 cases facing high quality restrictions Scheimpflug lens photography (SLP) was performed before and after surgery with SOT to measure the increase of transparency loss for the anterior, center and posterior segment of the lens.Because of potentially age related lens changes, we sorted the eyes into 4 groups (group1: 66 – 75, group2: 56 – 65, group3: 46 – 55, group4: 25 – 45 years old). After measuring the lens thickness of all examinations in 0° and 90°, for group1 to group3 (comparable lens thicknesses) we designed a reference body with a diameter of d=3mm, a height of h=1.65mm and a mean thickness of l=4.23mm and for the youngest group4 (thinner lenses) a reference body with d=3mm, h=1.4mm and l=3.76mm.
The retinal re-attachment rate was highest in the prospective pseudophacic group (p = 0.039). All reductions of lens transparency were measured with the Wilcoxon-matched-pairs test. Except for group4, we found significant effects of lens maturation (p ≤ 0.05) for the whole lens.Regarding the segments, group3 had a significant lens maturation in all parts of the lens (Fig.1), whereas group2 responded significantly in the anterior and center part (p=0.004), but not posteriorly (p=0.375). The oldest group1 reacts less than the middle age, the biggest effect was seen for the anterior part (p=0.094).In opposite to group1-3, the youngest group did not show any significance. The highest effect with p=0.250 was found in the posterior part.
Surgery for managing retinal detachments with PVR using silicone oil seems to take profit from preoperative cataract removal. Significant lens changes were found in all three segments of the lens. This corresponds to the histology of the lens epithelium published before.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Fig.1 Patient sample of group3. Three-dimensional lens densitometry pre- (left) /post (right) vitreoretinal surgery with preliminary silicone oil fill, measurements in three segments: upper line: anterior segment; middle line: nucleus; lower line: posterior segment Red cylinder: reference body.
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