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Virgilio Morales-Canton, Efrain Romo-Garcia, Jans J. Fromow-Guerra, Jose Luis Guerrero-Naranjo, Juan Manuel Jimenez-Sierra; Silicone Oil Removal Through a 23-Gauge Sclerotomy: Introduction of a Low-Cost Effective Technique. Invest. Ophthalmol. Vis. Sci. 2011;52(14):531.
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To describe an effective low-cost technique of silicone oil removal through a 23g sclerotomy.
We performed silicone oil removal with our new low-cost effective technique in 12 patients. 8 have had vitrectomy for diabetic retinopathy tractional detachment and 4 had a previous rhegmatogenous retinal detachment that required silicon oil tamponade.Our removal is based on creating suction in a 20-mL syringe and using the resultant vacuum to aspirate the silicone oil from the vitreous cavity. We cut a disposable 23g infusion tube and connect it to the 20-mL syringe through a 3 way stopcock. With the stopcock turned "off" toward the syringe we create vacuum and maintain it by inserting a 5-mL syringe side upwards, after this, the 23g trocar is introduce in the "short" infusion tube lumen and the stopcock its turn towards the side port to begin aspiration.
We performed a successful silicone oil removal in all our patients. The mean silicone oil removal time was 6.15 + 2.60 minutes (range 4 - 9 minutes). Suture placement was only necessary in two eyes, in one case the superotemporal sclerotomy continue to leak, and in the other case there were no leakage of sclerotomies but was the only functional eye of the patient. At follow up, we found no clinically significant residual oil in the vitreous cavity.
Our results suggests that this technique is simple, safe, and efficient. The material availability make it a low-cost procedure. It can also be applied to any bussy practice due to OR/procedure time that takes to do it. Another advantage of using a 23g vitrectomy system is the need of no suturing the sclerotomies lowering even more the cost of the preocedure.
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