Sutureless Phacoemulsification With Transpupillary Removal of Silicone Oil and Intracapsular Intraocular Lens Implantation Using Illuminated 23-Gauge Infusion System

Elbaha, Samir; Abouhussein, Mahmoud Alaa; Hemeida, Tarek S

doi:10.1097/iae.0b013e318200921b

Cited by 7 publications

(4 citation statements)

References 18 publications

(18 reference statements)

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“…The timing of the removal of the crystalline lens did not appear to influence the rate of re-detachment in our study or in the literature. El Baha et al demonstrated the re-detachment in 6.9% (n = 3) of patients after combined phacoemulsification and SOR, 7 whilst Scharwey et al demonstrated re-detachment in 2.7% (n = 1) of patients after silicone removal following a previous combined phacovitrectomy, 8 and Kaya et al demonstrated a 2.5% (n = 3) rate of re-detachment after SOR regardless of the timing of phacoemulsification. 9 The issue with our study that may have influenced a relatively low rate of re-detachment is the short follow-up period after SOR; however, the incidence of re-detachment is known to drop steeply as time progresses after SOR.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple reports of combined phacoemulsification with anterior approach SOR have reported transient postoperative corneal oedema. 7,23,24 The efflux of silicone oil and its contact with corneal endothelium has been shown to cause endothelial changes, but these changes were not significant when compared to endothelial changes of phacoemulsification alone. 25 Interestingly, even when silicone oil is removed through the pars plana -as in our patients -corneal oedema has been reported to develop transiently in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

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Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study

Helmy

Dahab

Abdelhakim

et al. 2020

African Vision and Eye Health

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Performing a staged procedure is advocated to overcome some of the intraoperative difficulties and postoperative complications that may occur with a combined procedure. These complications would not normally occur with vitrectomy alone, including corneal oedema, narrow pupil intraoperatively, and anterior chamber reaction with fibrinous exudate formation and posterior capsular opacification postoperatively. 5Background: A cataract inevitably develops after pars plana vitrectomy (PPV) with silicone tamponade. In patients with rhegmatogenous retinal detachment (RRD) of presbyopic age and without significant cataracts, phacoemulsification can be deferred to the time of silicone removal. Alternatively, it can be performed with PPV. Sparse evidence exists to choose one option over the other; this is usually left to the surgeon's preference.Aim: To compare PPV with silicone tamponade alone, or combined with phacoemulsification for primary RRD, in patients without significant cataracts.Setting: This is a comparative prospective randomised interventional study that was conducted in Cairo University hospitals. Methods:The patients were randomised to two groups, each with 20 phakic patients presenting with RRD. Patients in Group A were randomised to PPV, followed by the phacosilicone removal. Patients in Group B were randomised to phaco-vitrectomy, followed by silicone removal. Results:No statistically significant difference existed between the groups regarding the rate of intraoperative complications. Group B patients had a higher rate of early postoperative complications (intraocular pressure [IOP], corneal oedema and anterior chamber reaction). At final follow-up there was no statistically significant difference between the groups regarding the rate of retinal attachment or the best corrected visual acuity. Calculation of lens power was significantly more accurate in Group A, as evidenced by the difference in the mean spherical equivalent (Group A: -0.75 dioptre [D] vs Group B: -2.5 D, p = 0.031). Conclusion:This study suggests that no difference exists between the surgical options regarding anatomical success and intraoperative complications. Deferring phacoemulsification until the time of silicone oil removal offers an option with fewer early postoperative complications and more accurate lens power calculation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study

Helmy

Dahab

Abdelhakim

et al. 2020

African Vision and Eye Health

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“…In this study, we compared the incidence of silicone oil removal related complications in two different removal approaches. Transpupillary silicone oil removal combined with cataract surgery has been reported previously with an infusion cannula connected to balanced salt solution [ 11 ]. But in this study we provide a sclerotomy-free way to extracted silicone oil with minimum injury in contrast to traditional three-port sclerotomy method.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of transpupillary silicone oil removal in combination with micro-incision phacoemulsification cataract surgery: comparison with 23-gauge approach

Cheng

Zhuang

et al. 2018

BMC Ophthalmol

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BackgroundTo evaluate safety and efficacy of transpupillary silicone oil removal combined with micro-incision phacoemulsification cataract surgery, and to compare results of transpupillary with 23-gauge three-port vitrectomy approach.MethodsConsecutive cases that underwent silicone oil removal using either transpupillary or three-port approach in combination with micro-incision phacoemulsification cataract surgery were retrospectively reviewed. The main outcome measures were postoperative detachment rate, silicone oil residuals, best corrected visual acuity (BCVA) and intraocular pressure (IOP).ResultsA total of 64 cases were included, 19 in transpupillary and 45 in three-port. Postoperative detachment rate within 3 months in transpupillary versus three-port was 15.8% versus 4.4% (p = 0.14), Silicone oil residuals was 7.4 ± 3.2% versus 7.1 ± 2.8% (transpupillary vs. three-port, p = 0.71). Preoperative versus postoperative BCVA (logMAR) was 1.49 ± 0.61 versus 1.42 ± 0.61 in transpupillary approach (p = 0.28) and 1.53 ± 0.48 versus 1.45 ± 0.57 in three-port approach (p = 0.11). Transpupillary approach resulted in lower IOP at postoperative day 2 (12.2 ± 2.3 mmHg vs. 13.5 ± 2.2 mmHg, p < 0.05), while postoperative follow-up at 1 month revealed no significant difference (p = 0.21).ConclusionsTranspupillary silicone oil removal combined with micro-incision phacoemulsification cataract surgery is less invasive and can be an alternative in some circumstances.

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“…Phacoemulsification combined with a ROSO surgery is the most effective and convenient method to restore eyesight and is a less invasive method. [7][8] However, inflammation after the operation remains trouble for eye surgeons. Here, the use of blood thinners or enoxaparin such as Enoxaparin Sodium presents a solution to the inflammation problem.…”

Section: Introductionmentioning

confidence: 99%

Comparison of visual acuity and post-operative inflammation in phacoemulsification and removal of silicone oil with and without injection of Enoxaparin Sodium (40mg/0.04ml)

Buksh¹,

Khaqan²,

Imtiaz³

et al. 2021

J Fatima Jinnah Med Univ

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Background: Phacoemulsification and removal of silicone oil (ROSO) is a combined, frequently done procedure in retina theatre. A common problem in this procedure is the post inflammation that affects the recovery of the patients. Thus to counter this post-operative inflammation, the study has used Enoxaparin Sodium (an anti-inflammatory enoxaparin) to counter the post-operative inflammation in phacoemulsification and ROSO. Patients and methods: Prospective interventional study done at Ophthalmology Department, Lahore General Hospital, included 60 patients which were operated and observed for results over a period of 3 months. Total 60 patients were randomly allocated in two groups, Group A and B. Both groups underwent phacoemulsification and ROSO. Group A had Enoxaparin Sodium, admixed in infusion bottles with a dosage of 40mg/0.04ml while Group B was operated without Enoxaparin Sodium. Patients were examined on slit lamp on the 1st day after the surgery then on the 7th day and every month for 3 months for post-operative inflammation and visual recovery. The effectiveness of the procedure was defined by the comparison of post-operative inflammation as well as speedy recovery of sight. Results: Total 60 patients were randomly allocated in two groups. Group A had 30 patients, 23 males and 7 females, with mean age of 49.43 years. Group B included 30 patients, 19 males and 11 females, with mean age of 47.73 years. Post-operative BCVA in Group A was above vision 6/60 (Snellen’s Chart) in 90% of cases while it improved to vision 6/36 and better in 93% of cases at 7th day while 93% of cases crossed recovery of Vision 6/18 by 3rd Month. While in Group B, Vision 6/60 was observed in 70% of cases while it improved to vision 6/36 and better in 67% of cases at 7th day while 53% of cases crossed recovery of vision 6/18 by 3rd Month. Post-operative results for inflammation of Group B showed grade 3 reaction on first day (94%) while it reduced to grade 2 reaction on 7th day in 97% of the cases. While Group A was observed with occasional activity in 25 out of 30 cases (84%) on the first day and grade 2 reaction in 5 (16%) cases. 100% cases of Group A showed occasional activity on 7th day with better visual recovery. Conclusion: Intraoperative use of Enoxaparin Sodium helped in reducing post-operative inflammation as well as aided in better visual acuity after phacoemulsification and ROSO thus proving to be a viable enoxaparin agent to reduce post-operative reactions in these surgeries.

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Sutureless Phacoemulsification With Transpupillary Removal of Silicone Oil and Intracapsular Intraocular Lens Implantation Using Illuminated 23-Gauge Infusion System

Cited by 7 publications

References 18 publications

Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study

Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study

Safety and efficacy of transpupillary silicone oil removal in combination with micro-incision phacoemulsification cataract surgery: comparison with 23-gauge approach

Comparison of visual acuity and post-operative inflammation in phacoemulsification and removal of silicone oil with and without injection of Enoxaparin Sodium (40mg/0.04ml)

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