June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
A comparative study of the safety and efficacy of active silicone oil removal using either 23 or 25-gauge transconjunctival sutureless vitrectomy systems
Author Affiliations & Notes
  • Leonardo Cunha
    Ophthalmology, Universidade Federal de Juiz de Fora , Juiz de Fora , Minas Gerais, Brazil
    Ophthalmology, University of São Paulo , São Paulo , São Paulo, Brazil
  • Leandro C Zacharias
    Ophthalmology, University of São Paulo , São Paulo , São Paulo, Brazil
  • Luciana Virgínia Ferreira Costa-Cunha
    Ophthalmology, Hospital de Olhos Juiz de Fora , Juiz de Fora, Minas Gerais, Brazil
  • Pedro Guilherme Costa Ponte
    Ophthalmology, Universidade Federal de Juiz de Fora , Juiz de Fora , Minas Gerais, Brazil
  • Mario R Monteiro
    Ophthalmology, University of São Paulo , São Paulo , São Paulo, Brazil
  • Footnotes
    Commercial Relationships   Leonardo Cunha, None; Leandro Zacharias, None; Luciana Costa-Cunha, None; Pedro Guilherme Ponte, None; Mario Monteiro, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5004. doi:
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      Leonardo Cunha, Leandro C Zacharias, Luciana Virgínia Ferreira Costa-Cunha, Pedro Guilherme Costa Ponte, Mario R Monteiro; A comparative study of the safety and efficacy of active silicone oil removal using either 23 or 25-gauge transconjunctival sutureless vitrectomy systems. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5004.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Several techniques may be used for silicone oil removal (SOR), classically by two-port cannula system through infusion of saline solution and passive efflux of silicone oil (SO) through a 20-gauge(G) sclerotomy. With the advent of transconjunctival suturuless vitrectomy systems (TSVS), a passive approach for low-viscosity SOR has been reported, generally using a 23-G system. On the other hand, passive SOR with the 25-G system may require high infusion pressure and increase the risk of residual oil droplets postoperatively. Recent commercially available active systems made both 23 and 25-G systems possible for SOR but to our knowledge, no previous study compared the safety and efficacy of the two sized systems. Thus, the purpose of this study was to compare the safety and efficacy of SOR with 23 and 25-G TSVS.

Methods : Comparative, retrospective study of 42 eyes of 42 patients submitted to pars plana (PP) vitrectomy surgery for retinal detachment (RD) with SO (1300 centistokes) injection followed by active PP SO removal with either 23-G or 25-G TSVS between January 2013 and August 2016. The main outcome measures were the SOR time, presence of retained silicone oil droplets and intra and postoperative complications.

Results : The data of 23 eyes submitted to SOR with 23-G TSVS and 19 eyes with 25-G were included. The vast majority presented with rhegmatogenous RD. For 23-G group the mean age was 54.04 (±17.60) years and in 25-G group 52.58 (±15.81) years (P=0.5). The mean SOR surgical time was 2.58(±2.24)minutes in 23-G group and 5.08(±2.80)minutes in 25-G group (P=0.5). There was a positive correlation between the time of SOR and axial length(Fig. 1). No sclerotomy sutures were necessary. In each groups, 2 patients presented with retinal redetachment postoperatively. In both groups, there were no cases of hypotony, endophthalmitis, choroidal detachment, corneal endothelial decompensation, macular edema or retained silicone oil droplets.

Conclusions : No significant difference in the SOR time or in the incidence of complications was observed between the two groups. Removal of 1300 centistokes SO with both 23-G and 25-G TSVS seems to be an effective and safe method, therefore both methods can be routinely used in cases of SO extraction.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Figure 1: Scatter plots of axial length and silicone oil removal time.

Figure 1: Scatter plots of axial length and silicone oil removal time.

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