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Dilsher S. Dhoot, Alex Yuan, Jonathan E. Sears, Rishi P. Singh; Removal Of Silicone Oil With 25 Gauge Instrumentation Following Rhegmatogenous Retinal Detachment Repair. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6148.
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To determine if silicone oil removal is feasible using a commercially available 25 gauge vitrectomy system.
Six patients (6 eyes) underwent silicone oil removal in a prospective, interventional case series at a single institution, between October 2010 and December 2010. A 25-gauge system featuring a commercially available 25 gauge silicone oil injection cannula (Synergetics, O’Fallon, MO) was utilized for active removal of 1000 centistokes (cSt) silicone oil. Visual acuity, intraocular pressure (IOP), total silicone oil removal time, complications, and number of sutured sites were recorded in each case.
Mean active silicone oil removal time was 6 minutes and 3 seconds (SD, 83 seconds). 50% of the silicone oil removal sclerotomies were sutureless. Of those sclerotomies that did require suturing, a single interrupted transconjunctival scleral suture was effective at closing the sclerotomy. Mean pre-operative IOP was 14.2 mmHg (range, 10-18 mmHg). Mean one day and one week post-operative IOP was 8.2 (range, 5-13 mmHg) and 14.7 (range, 9.5-22 mmHg), respectively. No cases of post operative hypotony (IOP < 5 mmHg) were noted. Mean pre-operative visual acuity was 20/209. No intraoperative or postoperative surgical complications were identified. No residual oil was noted in the vitreous or anterior chamber on clinical exam in any of the eyes during the post operative visits. Mean one day and one week post-operative visual acuity was 20/1621 and 20/645, respectively.
We report a new method for active removal of 1,000 cSt silicone oil using a commercially available 25 gauge system. This procedure is less invasive than traditional 20g silicone oil removal, allowing for faster recovery. Longer follow-up and more patient data is ultimately needed to determine the true efficacy of this technique.
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