Purchase this article with an account.
M. Sacchi, E. Carini, S. De Cillà, S. Mattioli, N. Orzalesi; Corneal Involvement After 23-Gauge Vitrectomy With Silicone Oil Endotamponade for Retinal Detachment: An in vivo Confocal Microscopy Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3790.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Corneal changes after PRK, Lasik, corneal transplant using in vivo confocal microscopy (IVCM) are well known and recently we reported changes after cataract surgery (Sacchi et al ARVO 2009). Aim of this study was to investigate corneal involvement after vitrectomy with silicone oil infusion (SOI) for retinal detachment (RD) using IVCM.
10 consecutive patients (mean age 69±12 years) with RD treated with 23 gauge vitrectomy and SOI were enrolled in this prospective study. All patients were pseudophakic. Retinal breaks were treated with cryotherapy and/or endosurgical argon laser (mean spots 141±56.12). Ophthalmological and corneal confocal microscopy examination were performed at 1 week and 1, 3, 6 month after surgery in both eyes. The healthy eye was used as control. Exclusion criteria were oil bubble in anterior chamber, diabetes, cataract surgery less than 1 year before vitrectomy, ocular surface disease and chronic topical treatment. The following corneal parameters were investigated: sub-basal plexus nerve fibers, dendritic cell number, stromal keratocyte activation, endothelial cell number.
Mean nerve fiber number per frame was 4.14 ±0.69 in the control eye whereas no fibers were detectable at any time of follow-up in the study eyes (p=.00). Dendritic cell number per frame was significantly increased (23±4, 32±6, 18±5, 21±7,) compared to control eyes (3±2, 2±3, 6±2, 5±2) at 1 week and 1, 3, 6 months respectively (p<.05). Stromal keratocyte activation graded according to Martone et al (Am J Ophthalmol. 2009) was significantly higher (p=.05) in the study eye and endothelial cell number was significantly lower in the study eye compared to control eye (p=.01).
This study showed a disappearance of sub-basal plexus nerve fibers and a long lasting inflammatory condition in the sub-basal and anterior stromal layers after RD surgery. Studies with larger sample size and longer follow-up are advisable to better clarify this issue. Moreover the importance of other risk factors (duration and extent of detachment, amount of cryotherapy and laser, etc) should be investigated.
This PDF is available to Subscribers Only