Objectives: To compare the effectiveness of fluid-air exchange with silicone oil-fluid exchange in reducing the residual silicone oil (SO) droplets after the removal of SO. Methods: This was a prospective, quasi-experimental study conducted from October 2021 to February 2022 at Eye Unit-III, COAVS, Mayo Hospital, Lahore. Sixty-one patients with siliconized eyes underwent removal of SO with two different techniques and were divided into fluid-air exchange and oil-fluid exchange groups. To quantify the residual silicone droplets objectively, B-scan echographic images were analyzed within seven days of surgery. Silicone oil index (SOI) which is the amount of residual SO droplets/vitreal area in the images was calculated with the help of imagej software. Results: The residual SOI of the fluid-air exchange group (0.99 ± 1.76%) was significantly lower than the oil-fluid exchange group (3.25 ± 3.85%). The SOI is positively correlated with the duration of tamponade, preoperative intraocular- pressure and axial length. Persistent IOP elevation post-operatively was seen in 16.67% individuals in the fluid-air exchange group and 54.8% individuals in the oil-fluid exchange group. Conclusion: Fluid-air exchange group was found to be superior in reducing residual SO droplets than the oil-fluid exchange group. doi: https://doi.org/10.12669/pjms.39.2.6243 How to cite this: Rizwan A, Javaid RMM, Latif S, Sarwar MS, Khan AA. Comparison of residual silicone oil index after removal of silicone oil with fluid-air versus oil-fluid exchange. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.6243 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose:  To compare the frequency of hypotony after 23-gauge (G) pars plana vitrectomy (PPV) with suture-less sclerotomy versus intrascleral hydration for sclerotomy closure in eyes with air/gas tamponade. Study Design:  Quasi-experimental study. Place and Duration of Study:  College of Ophthalmology and Allied Vision Sciences, Mayo Hospital, Lahore from November 2021 to May 2022. Methods:  A total of 90 eyes were included who underwent PPV with air/gas tamponade. One group underwent PPV with suture-less sclerotomy while the other got intrascleral hydration for sclerotomy closure. Intraocular pressure (IOP) was measured pre and post-operatively at day one and day seven by applanation tonometry in all eyes. IOP of 6 mmHg or less was defined as hypotony. Primary endpoint measure was rate of early post-operative hypotony. Results: A total of 90eyes of 90 patients, 40 (44.4%) males, and 50 (55.6%) females were included in the study. Five (5.6%) patients reported hypotony, out of which, only one (2.2%) case was seen in the intrascleral hydration group while rest (8.9%) were of the sutureless group. Sclerotomies requiring sutures were 4.44% (6 of 135) in sutureless group while 0.74% (1 of 135) in intrascleral hydration group. Paired sample T-test for the means of pre-operative and post-operative IOP was significantly different in both groups. For suture-less PPV, mean difference was 3.089 ± 7.960 mmHg (P = 0.013), while for the intra scleral hydration group, it was 3.778 ± 7.048 mmHg (p = 0.001). Conclusion:  Intrascleral hydration is a suitable option for PPV sclerotomy closure without having any side effects.