Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7729-7737
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7729
Clinical effect of peripheral capsule preservation in eyes with silicone oil tamponade
Bo Jiang, Su Dong, Ming-Hao Sun, Zhong-Yu Zhang, Da-Wei Sun
Bo Jiang, Su Dong, Ming-Hao Sun, Zhong-Yu Zhang, Da-Wei Sun, Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Author contributions: Jiang B performed the majority of experiments and wrote the manuscript; Sun DW designed the study and revised the manuscript; Sun MH and Zhang ZY participated in data collection; Dong S took charge of the analytical tools; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Second Affiliated Hospital of Harbin Medical University Institutional Review Board (Approval No. KY2021-012).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: Surgical techniques and statistical data can be obtained from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da-Wei Sun, MD, PhD, Chief Doctor, Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang District, Harbin 150001, Heilongjiang Province, China. sun.dawei@hotmail.com
Received: May 7, 2021
Peer-review started: May 7, 2021
First decision: June 6, 2021
Revised: June 16, 2021
Accepted: July 20, 2021
Article in press: July 20, 2021
Published online: September 16, 2021
Abstract
BACKGROUND

At present, silicone oil has been widely used in vitrectomy to deal with complex fundus diseases. Usually, cataract extraction is combined with vitrectomy. However, reducing the complications of silicone oil tamponade and facilitating the secondary implantation of intraocular lens (IOL) are still an urgent problem.

AIM

To evaluate the clinical effect of vitrectomy combined with peripheral capsule preservation (PCP) in eyes with silicone oil tamponade.

METHODS

This single-center retrospective analysis included 70 patients (73 eyes) who underwent vitrectomy and silicone oil tamponade combined with cataract surgery (stage I) between January 2015 and July 2019. All patients underwent selective reoperation for silicone oil extraction and IOL implantation (stage II) more than 3 mo after stage I. These patients were divided into three groups according to the different lens capsule preservation methods: 28 patients (31 eyes) in a whole capsule preserved (WCP) group, 17 (17 eyes) in a capsule absent (CA) group, and 25 (25 eyes) in a peripheral capsule preserved (PCP) group. Intraocular pressure (IOP), best-corrected visual acuity, surgery time, and other complications were recorded at each time point (1 d, 1 wk, and 1 mo after stages I and II).

RESULTS

The IOP values were 14.9 ± 8.2 mmHg in the WCP group, 20.3 ± 13.0 mmHg in the CA group, and 14.2 ± 9.7 mmHg in the PCP group (P < 0.05) at 1 mo after stage I operation. Five eyes had IOP higher than 30 mmHg, and one eye in the WCP group appeared to have silicone oil entering the anterior chamber. There was no significant difference in IOP among the three groups at any other time point (P > 0.05). With IOL implantation, visual acuity improved significantly compared to stage I. The incidence rate of posterior capsule opacity was higher in the WCP group than in the other groups (P < 0.001). In the CA group, IOL deviation due to suture relaxation occurred in one case. There was no significant difference in the surgery time among the three groups in stage I (P = 0.618). In stage II, the surgery time of the PCP group and WCP group was significantly shorter than that of the AC group (P = 0.031).

CONCLUSION

Preservation of the peripheral capsule in vitrectomy combined with lens removal is a better option. This method has significant advantages in reducing intraoperative and postoperative complications.

Keywords: Vitrectomy, Silicone oil tamponade, Peripheral capsule preservation, Intraocular lens implantation

Core Tip: This study retrospectively analyzed and compared the clinical effects of vitrectomy combined with cataract extraction in silicone oil-filled eyes under three different capsule retention conditions, including whole capsule preserved, capsule absent, and peripheral capsule preserved. We would like to promote a new surgical method to preserve the peripheral capsule membrane, effectively preventing silicone oil from entering the anterior chamber and reducing the operation time and complications associated with intraocular lens implantation.