Silicone oil as a corneal lubricant to reduce corneal edema and improve visualization during

AIM:To evaluate the efficacy and safety of silicone oil(SO)as a corneal lubricant to improve visualization during vitrectomy.METHODS:Patients who underwent vitreoretinal surgery were divided into two groups.Group 1 was operated on with initial SO(Oxane 5700)as a corneal lubricant.Group 2 was operated on with initial lactated ringer’s solution(LRS)and then replaced with SO as required.Fundus clarity was scored during the surgery.Fluorescein staining was performed to determine the damage to corneal epithelium.RESULTS:Totally 114 eyes of 114 patients were included.Single SO use maintained a clear cornea and provided excellent visualization of surgical image.In group 1,the fundus clarity was grade 3 in 41/45 eyes and grade 2 in 4/45 eyes.In group 2,corneal edema frequently occurred after initial LRS use.The fundus clarity was grade 3 in 19/69 eyes,2 in 37/69 eyes and 1 in 13/69 eyes(P<0.05).SO was applied in 29 eyes of initial LRS use with subsequent corneal edema,which eliminated the corneal edema in 26 eyes.Corneal fluorescein staining score in group 1 was 0 in 28 eyes,1 in 11 eyes and 2 in 6 eyes,and 40,20 and 9,respectively,in group 2(all P>0.05).CONCLUSION:The use of SO as a corneal lubricant is effective and safe for preserving and improving corneal clarity and providing clear surgical field during vitrectomy.

Silicone oil migrating into the conjunctival space and orbit after surgery for an eye-penetrating injury:A case report

BACKGROUND We report a case of eye-penetrating injury in which a massive silicone oil migration into the patient’s subconjunctival space and orbit occurred after vitrectomy.CASE SUMMARY A 30-year-old male patient sought medical attention at Ganzhou People’s Hospital after experiencing pain and vision loss in his left eye due to a nail wound on December 9,2023.Diagnosis of penetrating injury caused by magnetic foreign body retention in the left eye and hospitalization for treatment.On December 9,2023,pars plana vitrectomy was performed on the left eye for intraocular foreign body removal,abnormal crystal extraction,retinal photocoagulation.Owing to the discovery of retinal detachment at the posterior pole during surgery,silicone oil was injected to fill the vitreous body,following which upper conjunctival bubble-like swelling was observed.Postoperative orbital computed tomography(CT)review indicated migration of silicone oil to the subconjunctival space and orbit through a self-permeable outlet.On December 18,2023,the patient sought treatment at the First Affiliated Hospital of Nanchang University,China.The patient presented with a pronounced foreign body sensation following left eye surgery.On December 20,2023,the foreign body was removed from the left eye frame and an intraocular examination was conducted.The posterior scleral tear had closed,leading to termination of the surgical procedure following supplementary laser treatment around the tear.The patient reported a significant reduction in ocular surface symptoms just one day after surgery.Furthermore,a notable decrease in the migration of silicone oil was observed in orbital CT scans.CONCLUSION The timing of silicone oil injection for an eye-penetrating injury should be carefully evaluated to avoid the possibility of silicone oil migration.

Axial length,vitreoretinal pathology,and anterior chamber depth can predict postoperative refractive outcomes in phacovitrectomy/silicone oil removal

AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P<0.01).Univariate analysis revealed that longer eyes(AL>26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.

Predictive factors of epiretinal membrane in complicated rhegmatogenous retinal detachment tamponaded with silicone oil

AIM:To determine the incidence and predictive factors for epiretinal membrane(ERM)formation in eyes with complicated primary rhegmatogenous retinal detachment(RRD)tamponaded with silicone oil(SO).METHODS:This retrospective case-control study included 141 consecutive patients with(51 eyes)and without(90 eyes)ERM formation after primary pars plana vitrectomy(PPV)and SO tamponade for complicated RRD.The risk factors for ERM were assessed using logistic regression analysis.RESULTS:The prevalence of postoperative ERM was 36.2%(51/141).Multivariate logistic regression analysis showed that the risk factors for ERM in SO-tamponaded eyes included preoperative proliferative vitreoretinopathy[PVR;odds ratio(OR),2.578;95%confidence interval(CI)1.580–4.205,P<0.001],preoperative choroidal detachment(OR,4.454;95%CI 1.369–14.498,P=0.013),and photocoagulation energy(OR,2.700;95%CI 1.047–6.962,P=0.040).The duration of the preoperative symptoms,intraocular SO tamponade time,giant retinal tear,preoperative vitreous hemorrhage,preoperative bestcorrected visual acuity,number of breaks,quadrants of RRD,axial length,and photocoagulation points were not predictive factors for ERM formation.CONCLUSION:Preoperative PVR,choroidal detachment,and photocoagulation energy are risk factors of ERM formation after complicated RRD repair.Better ophthalmic care as well as patient education are necessary for such patients with risk factors.

Retrolaminar migration as a complication of intraocular silicone oil injection detected on unenhanced CT

AIM:To describe the clinical and radiologic features of retrolaminar migration silicone oil(SiO)and observe the dynamic position of ventricular oil accumulation in supine and prone.METHODS:For this retrospective study,29 patients who had a history of SiO injection treatment and underwent unenhanced head computed tomography(CT)were included from January 2019 to October 2022.The patients were divided into migration-positive and negative groups.Clinical history and CT features were compared using Whitney U and Fisher’s exact tests.The dynamic position of SiO was observed within the ventricular system in supine and prone.CT images were visually assessed for SiO migration along the retrolaminar involving pathways for vision(optic nerve,chiasm,and tract)and ventricular system.RESULTS:Intraocular SiO migration was found in 5 of the 29 patients(17.24%),with SiO at the optic nerve head(n=1),optic nerve(n=4),optic chiasm(n=1),optic tract(n=1),and within lateral ventricles(n=1).The time interval between SiO injection and CT examination of migration-positive cases was significantly higher than that of migration-negative patients(22.8±16.5mo vs 13.1±2.6mo,P<0.001).The hyperdense lesion located in the frontal horns of the right lateral ventricle migrated to the fourth ventricle when changing the position from supine to prone.CONCLUSION:Although SiO retrolaminar migration is unusual,the clinician and radiologist should be aware of migration routes.The supine combined with prone examination is the first-choice method to confirm the presence of SiO in the ventricular system.

Intraocular Silicone Oil Removed after 10 Years: A Case Report

Background: Silicone oil (SO) has been demonstrated with concrete efficacy and safety in the therapy of complex vitreoretinal diseases. SO is schemed to be cleared within several weeks or months after tamponade, but it’s inevitable for permanent or residual SO in a fraction of patients under extremely complicated clinical conditions. Here, we presented a case of silicone oil removal after 10 years, mainly to observe the disadvantages of long-term persistence. Case presentation: A 69-year-old female with pathologic myopia denied trauma history who had undergone pars plana vitrectomy (PPV), retinal reattachment, laser, and silicone oil tamponade in 2012 presented to our hospital with eye pain and headache, no light perception of her right eye for six months. The slit-lamp biomicroscopy examination for OD indicated evident conjunctival congestion, new blood vessels invasion to the limbus, foggy edema of corneal epithelium, folds of Descemet’s membrane and corneal endothelial edema. There were obvious emulsified silicone oil particles above the anterior chamber. Goldmann’s applanation tonometry test revealed the intraocular pressure was as high as 45/17mmHg. From ocular ultrasound, we saw that the vitreous cavity was filled with silicone oil in right eye;as for the left eye, it showed marked axial elongation and posterior scleral staphyloma. We were unable to obtain more information from fundus photography and macular optical coherence tomography (OCT) due to edema of the cornea. After the silicone oil was removed successfully from her vitreous cavity, although there was no improvement in the patient’s vision (no light perception), she was still satisfied with the relief from eye pain and headache benefited from the reduction of high intraocular pressure (Goldmann’s intraocular pressure decreased to 19/14mmHg). Conclusion: Patients after PPV should remove silicone oil in time to avoid corneal damage, intraocular hypertension, lens opacity and retinal damage induced by long-term silicone tamponade.

Vitrectomy, lensectomy and silicone oil tamponade in the management of retinal detachment associated with choroidal detachment

AIM: To report the results of combined vitrectomy, lensectomy and silicone oil (SO) tamponade in treating primary rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (CD). · METHODS: A retrospective, consecutive and case series study of 21 subjects with concurrent RRD associated with CD was conducted. All subjects underwent a standard three -port 20G pars plana vitrectomy (PPV) with lensectomy and silicone oil tamponade. Mean follow -up time was 8 months (rang from 4 to 19 months). The primary and final anatomic success rate, visual acuity and final intraocular pressure (IOP) were recorded and analyzed. ·RESULTS: Of 21 subjects, 8 were women and 13 were men. Age at presentation ranged from 22 to 75 years (mean 57.4 years). The presenting vision ranged from light perception to 0.15. The initial IOP ranged from 3mmHg to 12mmHg (mean 6.2mmHg). All eyes were phakic except one pseudophakic. No intraocular lens was implanted during the primary surgical intervention. Fifteen of 21 (71.4%) eyes had retina reattached after one operation. Six eyes had recurrent inferior retinal detachment due to proliferation. Five of them were successfully reattached after one or more additional operations. Mean IOP at final follow -up was 15.2mmHg (range from 8mmHg to 20mmHg). One case declined for further operation. The final reattachment rate was 95.2%. Visual acuity improved in 19 (90.5%) eyes, was unchanged in 1 (4.8%) eye and decreased in 1 (4.8%) eye.·CONCLUSION: Combination of vitrectomy, lensectomy and silicone tamponade is an effective method in treating RRD associated with CD, reducing the incidence of postoperative hypotony.

Macular Perfusion Changes and Ganglion Cell Complex Loss in Patients with Silicone Oil-related Visual Loss

Objective The aim of this study was to investigate macular perfusion changes and ganglion cell complex(GCC)loss in patients with unexplained visual loss following vitrectomy and silicone oil(SO)tamponade,and to evaluate the correlation between retinal blood flow and GCC loss using optical coherence tomography angiography(OCTA)and optical coherence tomography(OCT).Methods This retrospective study included seven eyes(seven patients)with unexpected visual loss after vitrectomy and SO tamponade.OCTA was used to evaluate the alterations in retinal vessel density(VD)in the superficial capillary plexus(SCP),deep capillary plexus(DCP),and radial peripapillary capillary plexus(RPCP).OCT was used to measure the thickness of GCC and retinal nerve fiber layer(RNFL).Medical records of patients were reviewed.Results Quantitative analysis of OCTA images revealed a significant reduction in SCP VD in the affected eyes compared with the controls(all sections P<0.05).No difference was found in GCC thickness,but FLV(focal loss volume)and GLV(global loss volume)were significantly higher in the affected eyes(both P<0.001).SCP VD was inversely correlated with FLV and GLV.Conclusions Silicone oil-related severe visual loss was associated with superficial retinal microvasculature damage and ganglion cell apoptosis.

Analysis of the causative factors related to earlier emulsification of silicone oil

The aim of this study is to report and analyze the factors related with earlier occurrence of silicone oil(SO) emulsification in patients underwent pars plana vitrectomy and SO injection in our hospital. We retrospectively reviewed consecutive case series undergone both SO injection and removal in our hospital, and 182 ones were eligible. Possible related independent factors included: macula status(on/off), concomitant phacoemulsification with the surgery of SO tamponading, concomitant status of proliferative vitreoretinopathy, combined surgery of retinotomy, time to have emulsification(<6 mo/≥6 mo after primary SO injection), route of SO injection(anterior/posterior), lens status(aphakic/pseudophakic/phakic), anesthesia(local/general), brands and type of SO, with/without episcleral cryotherapy, with/without hypertension, with/without diabetes, with/without intraoperative use of triamcinolone acetonide. The study revealed that brand and type of SO was the significant factor related with earlier emulsification of SO. Further study was warranted to find out the underlying causes.

Vitrectomy combined with silicone oil tamponade in the treatment of severely traumatized eyes with the visual acuity of no light perception

AIM: To evaluate the efficacy of surgical treatment of vitrectomy combined with silicone oil tamponade in the treatment of severely traumatized eyes with the visual acuity of no light perception (NLP).METHODS: This was a retrospective uncontrolled interventional case-series of 19 patients of severely traumatized eyes with NLP who underwent vitrectomy surgery at the Affiliated Hospital of Medical College, Qingdao University (Qingdao, China) during a 3-year period. We recorded perioperative factors with the potential to influence functional outcome including duration from the injury to intervention; causes for ocular trauma; open globe or closed globe injury; grade of vitreous hemorrhage; grade of endophthalmitis; grade of retinal detachment; size and location of intraocular foreign body (IOFB); extent and position of retinal defect; grade of proliferative vitreoretinopathy (PVR); type of surgery; perioperative complications and tamponade agent. The follow-up time was from 3 to 18 months, and the mean time was 12 months.RESULTS: After a mean follow-up period of 12 months (3-18 months) 10.53% (2/19) of eyes had visual acuity of between 20/60 and 20/400, 52.63% (10/19) had visual acuity less than 20/400 but more than NLP, and 36.84% (7/19) remained NLP. Visual acuity was improved from NLP to light perception (LP) or better in 63.16% (12/19) of eyes and the rate of complete retinal reattachment was 73.68% (14/19). Good visual acuity all resulted from those patients of blunt trauma with intact eyewall (closed globe injury). The perioperative factors of poor visual acuity prognosis included delayed intervention; open globe injury; endophthalmitis; severe retinal detachment; large IOFB; macular defect; a wide range of retinal defects andsevere PVR.CONCLUSION: The main reasons of NLP after ocular trauma are severe vitreous hemorrhage opacity; refractive media opacity; retinal detachment; retinal and uveal damages and defects, especially defects of the macula; PVR and endophthalmitis. NLP after ocular trauma in some cases does not mean permanent vision loss. Early intervention of vitrectomy combined with silicone oil tamponade and achieving retinal reattachment of the remaining retina, may make the severely traumatized eyes regain the VA of LP or better.

Visual outcome after removal of silicone oil in patients undergoing retinectomy for complex retinal detachment

AIM：To evaluate the functional outcome after removal of silicone oil（ROSO）in patients undergoing retinectomy for complex retinal detachment.·M ETHODS：We performed a retrospective case note review of patients who underwent ROSO after retinectomy for complex retinal detachment.Patients with less than 6mo follow up and recurrent retinal detachment following ROSO were excluded.·RESULTS：Thirty-six patients were included.The mean best corrected visual acuity（BCVA）pre-ROSO was1.13 log MAR（SD 0.5）.The mean BCVA 3mo following ROSO was 1.16 log MAR（SD 0.53）,6mo following ROSO1.13（SD 0.63）,and 12mo following ROSO 1.18（SD 0.69）.At 12mo after ROSO,the BCVA improved in 38.9%of patients,remained unchanged in 25%,and deteriorated in 36.1%,although there was no statistical significant difference in BCVA after ROSO at 3,6 and 12mo（=0.93）.The size of retinectomy ranged from 15°to 270°（SD 53）and did not influence the visual outcome（=0.11）.·C ONCLUSION：There was no statistically significant difference in BCVA between pre-and post-ROSO following retinectomy for complex retinal detachment.There was no statistical difference in visual outcome related to the size of the retinectomy.

Comparison of Densiron 68 and 1 000 cSt silicone oil in the management of rhegmatogenous retinal detachment with inferior breaks

AIM:To compare success rates and complications of Densiron 68 and 1000cSt silicone oil (SO) in the management of rhegmatogenous retinal detachment (RRD) with inferior breaks (IBs). METHODS:Totally 61 eyes of 61 consecutive patients with RRD with IBs were assigned to pars plana vitrectomy (PPV) with Densiron (n =31) or PPV with SO (n=30) in order of presentation. SO and Densiron removal was performed 3 months after initial surgery. Follow up visits were terminated 6 months after SO removal. ·RESULTS:With a single operation, the Densiron group showed 84% and SO 74% reattachment. With further surgery, both groups showed 90% reattachment. Complications such as cataract, raised intraocular pressure (IOP), inflammatory reaction, macular epiretinal membranes, and emulsification of SO were seen in both groups. CONCLUSION:Densiron and SO are found to have similar success rates and complications.

Anatomical and functional outcomes after Densiron 68 heavy silicone oil tamponade for complicated retinal detachment in Chinese eyes

AIM:To evaluate the safety and efficacy of Densiron 68 heavy silicone oil (HSO) tamponade for complicated retinal detachment(RD)in Chinese eyes.METHODS:Twenty-one eyes of 21 patients with complicated RD were included in this retrospective study.All patients underwent pars plana vitrectomy with an internal tamponade using Densiron 68 HSO.Anatomical and functional results and complications were evaluated,including retinal status,visual acuity(VA),intraocular pressure(IOP),intraocular inflammation,lens opacity,and HSO emulsification.RESULTS:Allthepatients were followed up for 3mo to1y(5.8±1.16mo).Retinal reattachment was achieved in 19of 21 patients(90.5%).VA improved in 18 of 21 patients(85.7%),from 1.93 logMAR(±0.48)to 1.52 logMAR(±0.45)(P=0.001).Postoperative complications included early dispersion of HSO in 7 eyes(38.8%),cataract in 10 of 18phakic eyes(55.5%),moderate postoperative inflammation reaction in 10 eyes(47.6%),and elevated IOP in 5 eyes(23.8%),all of which were controlled by medication or by surgery.CONCLUSION:Highanatomical and functional success rates can be achieved with primary vitrectomy for complicated RD by using Densiron 68 HSO;however,it should not be ignored that Densiron 68 HSO can cause some complications in the eye.

Clinical presentation of a mixed 23-gauge infusion and 20-gauge pars plana technique for active silicone oil removal

AIM: To present with a clinical case series of a mixed 23-gauge infusion and 20-gauge pars plena technique for 5,700-centipoise silicone oil removal (SOR), and to discuss its efficacy and safety. METHODS: This is a retrospective, non-randomized controlled study. We performed SOR with 23-gauge infusion and 20-gauge active suction technique on 29 patients 29 eyes from April to October, 2011 (mixed group). During the surgeries, a 23-gauge sclerotomy was made for infusion and a 20-gauge sclerotomy was used for active silicone oil suction. Anterior segment optical coherence tomography (OCT) was applied for 23-gauge sclerotomy analysis 1 day post-operation. Traditional 20-gauge SOR was performed on another consecutive 29 patients 29 eyes, the control group (20G group). RESULTS: There were 2 eyes (6.9%) in mixed group and 5 eyes (17.2%) in 20G group which had recurrent retinal detachment after surgery. Hopytony (IOP <= 6mmHg) occurred in 8 eyes (27.6%) of mixed group and in 10 eyes (34.5%) of 20G group post-operation, but all of them recovered to the normal level finally. There were no statistical significant differences. Final visual acuity was significantly increased after surgery in both groups. Anterior segment OCT images were acquired from 13 eyes of mixed group, and all of them had a proper wound apposition. But local ciliary detachment was found in 9 eyes (69%). It was hard to define the OCT image of the sclerotomies and ciliary body because of the serious conjunctival hemorrhages and chemosis in 20G group. CONCLUSION: This mixed technique is a convenient and effective way to remove high viscosity silicone oil. Compared with traditional 20-gauge SOR, it does not increase the risk of post-operative complications and has less conjunctival reactions.. Transient postoperative hypotony is common for this procedure and subclinical ciliochoroidal detachment is a probable cause.

Efficacy and safety of active silicone oil removal through a 23-gauge transconjunctival cannula using an external vacuum pump

AIM: To evaluate the efficacy and safety of active removal of silicone oil with low and high viscosity through a 23-gauge transconjunctival cannula using an external vacuum pump.METHODS: This study was conducted as a prospective, interventional case series. A total of 22 eyes of 21 patients [1000 centistokes(c St): 17 eyes, 5700 c St:5 eyes] were included in this study. All patients underwent active silicone oil removal via the entire lumen of a 23-gauge microcannula with suction pressure of a650-700 mm Hg vacuum using an external vacuum pump. A tubing adaptor from the Total Plus Pak誖(Alcon,Fort Worth, USA) was used to join the microcannula and silicone vacuum tube connected to an external vacuum pump. Main outcome measures were mean removal time,changes of intraocular pressure(IOP) and visual acuity,and intraoperative and postoperative complications.RESULTS: Mean removal time(min) was 1.49±0.43 for1000 c St and 7. 12 ± 1. 27 for 5700 c St. The IOP was18.57±7.48 mm Hg at baseline, 11.68 ±4.55 mm Hg at day1 postoperatively(P <0.001), and 15.95±4.92, 16.82±3.81,17.41 ±3.50, and 17.09 ±3.01 mm Hg after one week, one month, three months, and six months, respectively. All patients showed improved or stabilized visual acuity.There was no occurrence of intraoperative or postoperative complications during the follow up period.CONCLUSION: This technique for active removal of silicone oil through a 23-gauge cannula using an external vacuum pump is fast, effective, and safe as well as economical for silicone oil with both low and high viscosity in all eyes with pseudophakia, aphakia, or phakia.

Effect of silicone oil on the microstructure, gelation and rheological properties of sorbitan monostearate–sesame oil oleogels

Oleogels contain oil or a non-polar liquid which is gelled with an agent called an organogelator. The aim of this study was to evaluate the effects of the addition of silicone oil(cyclopentasiloxane) to the gelation process and to the properties of sorbitan monostearate(SMS)–sesame oil oleogel and compared with that of SMS–sesame oil oleogel and SMS–cyclopentasiloxane oleogel. Three different oil phases; sesame oil phase, cyclopentasiloxane phase and a mixture of cyclopentasiloxane and sesame oil, were used to prepare oleogels with SMS gelator. The critical gelling concentrations(CGC) for oleogels were determined using different concentration of SMS in a range of 5%–22%(w/w). The characterization of the developed oleogels was done using Fourier transform infrared spectroscopy(FTIR), polarized light microscope, rheometer, X-ray diffraction(XRD) and differential scanning calorimetry(DSC). The addition of cyclopentasiloxane reduced the CGC of SMS–sesame oil oleogel from 20% to 10%(w/w). In microscopic characterization, the oleogels with a mixture of oil phases showed the longer and thicker three-dimensional gel network than that of oleogels with sesame oil and cyclopentasiloxane. FTIR studies demonstrated that this network formation was mainly due to hydrogen bonding. Rheological measurements revealed that the combination of cyclopentasiloxane and sesame oil produced strong gel with higher complex modulus values and longer linear viscoelastic region than oleogels prepared with sesame oil and cyclopentasiloxane. In addition, oleogels with the combination of the two oils had higher enthalpy( H m) and entropy( S m) thus could increase thermodynamic stability of the oleogels. Therefore, the addition of cyclopentasiloxane can improve the physical, ther-mal properties and stability of SMS–sesame oil oleogel, provide greater sensory profile and better product aesthetics. The developed oleogel can be a novel carrier for topical drug delivery.

A modified approach to actively remove high viscosity silicone oil through 23-gauge cannula

AIM：To report a simple approach to actively remove high viscosity silicone oil through a 23-gauge cannula via pars plana.METHODS：Forty-eight eyes of 48 patients underwent silicone oil（5700 centistokes） removal（SOR） were enrolled.A section of blood transfusion set was prepared to connect a standard 23-gauge cannula and vitrectomy machine.Silicone oil was removed with suction of500-mm Hg vacuum through the cannula.Main outcome measures were SOR duration,number of sutured sites,intraocular pressure（IOP）,best-corrected visual acuity（BCVA）,and complications.RESULTS：Silicone oil was successfully removed in all cases.The mean SOR time was 5.70±0.85 min.Nine eyes（18.75%） needed suture partial sclerotomies.No intraoperative complications were noted.Transient hypotony（≤8 mm Hg） was seen in 3 eyes（6.25%） on postoperative day 1,but all resolved within 1wk.Retinal reattachment was achieved in all cases and no other postoperative complications were noted during 3-month following-up.BCVA at the final visit improved or stabilized in all patients comparing to the preoperative level.CONCLUSION：Active removal of high viscosity silicone oil through a 23-gauge instrument cannula jointed with blood transfusion set is a practical and reliable technique when considering two sides of efficacy and safety.

Synthesis and Properties of Perfluorinated Alkyl Silicone Oil Modified Epoxy Resin

Perfluorinated alkyl silicone oil （PFASO） was successfully synthesized from N-ethyl-N- hydroxylethyl perfluorinated octane sulfonamide, succinie anhydride and amino silicone oil by esterification and amide reaction at moderate temperature in the presence of different catalysts. The chemical structure of the synthesized samples was characterized by Fourier transform infrared spectroscopy （FT-IR）, the relative molecular mass（MM） and molecular mass distribution（MMD） of PFASO were tested by gel filtration chromatography（GFC）. A commercial epoxy resin （DGEBA） was modified with PFASO, with the content of PFASO 1-5 phr. Thermo-gravimetric analysis （TGA）, impact tests, scanning electron microscope （SEM） and water contact angle test were applied to provide accurate results on the thermal stability, toughness and hydrophobicity of PFASO/epoxy complex. The experimental results reveal that epoxy resins can be successfully modified by adding a small amount of as-synthesized modifiers via simple direct mixing, and verify that the as-synthesized modifier can improve the toughness and hydrophobicity of epoxy resin without sacrificing its thermal properties.

Analysis of the rates of emulsification in intraocular silicone oil tamponades of differing viscosities

AIM:To investigate the rates of emulsification in silicone oil(SO)tamponades of differing viscosities used during pars plana vitrectomy(PPV)in the treatment of complicated vitreoretinal diseases.METHODS:This study was a prospective randomized clinical trial.Totally 290 cases with greater likelihoods of secondary detachment were included and randomly grouped into either Siluron 2000(n=143)or Siluron 5000(n=147)SO tamponades with 23-gauge PPV.Patient followups and data analyses were conducted 1,3,6,and 12 mo post-surgery.RESULTS:The time of the SO emulsification ranged from 1 to 17 mo,with a mean of 7.3±4.2 mo.The Siluron 5000 group showed a slower emulsification rate in comparison to the Siluron 2000 group.The Siluron 2000 group took a shorter time to show signs of emulsification,necessitating earlier SO removal.However,there were no significant differences in the occurrence of complications,including secondary retinal detachment,cataract,corneal abnormality,high intraocular pressure and hypotony.CONCLUSION:The Siluron 2000 SO tamponade shows a faster rate of emulsification than the Siluron 5000 SO,necessitating earlier removal.Both groups show similar results in terms of anatomical success and visual acuity outcome,and there is no significant difference between the SOs regarding the occurrence of complications.

Intracameral anti-VEGF injection for advanced neovascular glaucoma after vitrectomy with silicone oil tamponade

AIM: To evaluate the effect of intracameral injection of conbercept for the treatment of advanced neovascular glaucoma(NVG) after vitrectomy with silicone oil tamponade.METHODS: Conbercept 0.5 mg/0.05 m L was injected into the anterior chamber of 5 eyes, which had developed advanced NVG after vitrectomy with silicone oil tamponade. Then, trabeculectomy with mitomycin C and pan-retinal photocoagulation(PRP) or extra-PRP were conducted within 2 d. The follow-up time was 6 mo. Best-corrected visual acuity(BCVA), intraocular pressure(IOP), neovascularization of iris(NVI) were recorded before and after treatment.RESULTS: Within 2 d after injection, IOP control, and NVI regression were optimal for trabeculectomy. Hyphema occurred in one eye in the process of injection. But none of them present hyphema after trabeculectomy. At the end of follow-up time, all eyes had improved BCVA, well-controlled IOP, and completely regressed NVI. CONCLUSION: Intracameral injection of conbercept is safe and effective in the treatment of patients with advanced NVG after vitrectomy with silicone oil tamponade. Within 2 d after injection is the optimal time window for trabeculectomy, which can maximally reduce the risk of perioperative hyphema.