Comparison of Viscoelastic Substance Injection Versus Air Filling in the Anterior Chamber During Foldable Capsular Vitreous Body (FCVB) Implant Surgery: A Prospective Randomized Controlled Trial

Abstract

Introduction To compare the outcomes of viscoelastic substance injection with air filling in the anterior chamber during foldable capsular vitreous body (FCVB) implant surgery in patients with severe retinal disease. Methods Thirty eyes with severe retinal diseases were randomly divided into two groups. In the viscoelastic group, 0.15-0.2 mL of 1.7% sodium hyaluronate was injected into the anterior chamber after FCVB implantation; in the air group, the anterior chamber was maintained by filling the air after FCVB implant surgery. The eyes of treated patients were examined during a 24-week follow-up appointment. Data, including intraocular pressure (IOP), the difference between preoperative and postoperative IOP, and postoperative complications, were recorded. Results Data collected from 27 eyes were used in the final analysis. The IOP of the air group was lower than that of the viscoelastic group from the first to third postoperative day ( P < 0.01). Moreover, the difference between preoperative and postoperative IOP in the viscoelastic group was significantly smaller than that in the air group from the first to third postoperative day ( P < 0.01). After the 1st postoperative week, postoperative IOP values were similar in the two groups ( P > 0.05). Postoperative complications in the air group and the viscoelastic group included corneal blood staining (1 eye vs. 0 eyes), transient postoperative diffuse hemorrhage (5 eyes vs. 1 eye), inflammation reaction (9 eyes vs. 4 eyes), and postoperative fibrin exudation (4 eyes vs. 1 eye), respectively. Conclusion The use of viscoelastic substances in the anterior chamber during FCVB implant surgery was associated with less fluctuation in postoperative IOP and could reduce postoperative complications. Registration Number ChiCTR-TNC-00000396. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01840-5.

Foldable Capsular Vitreous Body Implantation for Complicated Retinal Detachment Caused by Severe Ocular Trauma

“…In our study, there was a case of a shallow anterior chamber after surgery, which may have been related to the insufficient amount of viscoelastic substance injected into the anterior chamber during the operation. Although filtered clean air can also be used to fill the anterior chamber to maintain the intraocular pressure and depth of the anterior chamber, the study by Zhang et al 27 showed that viscoelastic substances are better. Valve leakage and foreign body sensation can be avoided if the valve is made smaller in the future.…”

Evaluation of Foldable Capsular Vitreous Body Implantation Surgery

“… 10 Thus, we found that FCVB displayed better results in retinal reattachment, which is consistent with previous studies. 7 …”

“… Liu N et al 31 2021 5 SO-dependent eyes; 32.0(18–46) 3(5) 12 to 15 months Observed 5 patients of severe silicone oil-dependent eyes underwent FCVB implantation The FCVB is a safe, feasible, and effective vitreous substitute to maintain ocular morphology and intraocular pressure Xu X et al 5 2021 18 Ocular trauma; SO-dependent eyes 50.6(34–70) 17(18) 12 months Observed 18 patients who underwent vitrectomy and FCVB implantation for severe ocular trauma and silicone oil-dependent eyes FCVB implantation is an effective and safe treatment for eyes with severe ocular trauma and silicone oil-dependent eyes. Zhang Z et al 7 2021 27 RD; posterior trauma Air group:41.8±13.5 Viscoelastic group:42.4±14.2 Air group:10 (13) Viscoelastic group:11(14) 6 months To compare the outcomes of viscoelastic substance injection with air filling in the anterior chamber during FCVB implant surgery in patients with severe retinal disease. The use of viscoelastic substances in the anterior chamber during FCVB implant surgery was associated with less fluctuation in postoperative IOP and could reduce postoperative complications Abbreviations : RD, retinal detachment; CHD, choroidal detachment; SO, silicone oil.…”

“…10 Thus, we found that FCVB displayed better results in retinal reattachment, which is consistent with previous studies. 7 IOP is an essential factor in sustaining the shape of the eye. Previous studies have shown that post-vitrectomy hypotony is a well-recognized postoperative complication in eyes after severe PVR and severe ocular trauma surgery.…”

“…The surgical procedures are presented in previous studies. 7 ( Figure 1A ) A standard three-channel 23G PPV was performed to remove the original or residual vitreous, SO, or vitreous hemorrhage and layers of proliferation membranes. Then, we attempted to reattach the retina as well as possible.…”