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Jesse T McCann, Chandra Bala, Yale Fisher; Real-Time In-Vivo Correlation of Retained Vitreoretinal Adjuvants Poly(Dimethyl siloxane) and Perflouro-n-octane by Handheld High-Resolution B-Scan Ultrasound Biomicroscopy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1691. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The health of the pars plana and the presence of retained vitreoretinal adjuvants are important factors guiding the postoperative recovery of patients with vitreoretinal disease. High-resolution B-scan ultrasound, also known as ultrasound biomicroscopy (UBM) is an excellent technique for high-resolution three-dimensional imaging of the anterior segment. The development of self-contained handheld ultrasound biomicroscopy has expanded its clinical utility. High resolution ultrasound biomicroscopy provides a non-invasive method for the detection of retained vitreoretinal adjuvants in patients with a history of intravitreal injection and pars plana vitrectomy.
Ultrasound biomicroscopy with a 40-mHz handheld probe was used to examine patients after intravitreal injection and postoperative vitreoretinal surgery was used assess pars plana wound healing, ciliary body and cleft structure, and intraocular lens placement on eyes after intravitreal injection and pars plana vitrectomy. Patients were screened for the presence of residual surgical adjuvants poly(dimethyl siloxane) (silicone oil) and perfluoro-n-octane.
Real-time handheld ultrasound video-microscopy of the pars plana with 33-µm lateral resolution were obtained using a handheld UBM probe. Thirty (30) eyes of twenty-six (26) patients with a history of vitrectomy with use of adjuvants or intravitreal anti-VEGF injections using silicone-lubricated syringes were visualized. Persistence of vitreoretinal surgical adjuvants including silicone oil and perfluoro-n-octane were visualized in the pars plana with tell-tale hyperechogenic opacities with hypoechogenic tails. Sclerotomy construction and wound healing was monitored over the first postoperative month period. Silicone oil droplets have been observed in the formed vitreous of patients after intravitreal injections of anti-VEGF.
Longitudinal high-resolution monitoring of the pars plana is a useful adjuvant in monitoring vitreoretinal surgery and complications. Noninvasive measurement of scleral thickness, ciliary body injuries, retained surgical adjuvants and implant positioning can guide surgical decision-making. Handheld ultrasound biomicroscopy will provide improved visualization of vitreo-retinal pathologies in a method that is accessible to the surgeon in real-time.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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