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
Processing time: 125 Days and 20.7 Hours
ARTICLE HIGHLIGHTS
Research background

In order to better treat complex fundus diseases, cataract extraction is widely combined with vitrectomy due to the influence of lens opacity on fundus observation or lens problems before vitrectomy.

Research motivation

Long-term silicone oil tamponade will cause some complications, especially when silicone oil enters the anterior chamber. It is difficult to remove silicone oil when the anterior chamber of an eye has lens or intact lens capsule. However, in the second stage of silicone oil extraction and intraocular lens (IOL) implantation, IOL implantation becomes a challenge due to the loss of capsular support in aphakic eyes.

Research objectives

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

Research methods

This single-center retrospective study analyzed the patients who underwent vitrectomy and silicone oil tamponade combined with cataract surgery (stage I). 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 used: Whole capsule preserved (WCP) group, capsule absent (CA) group, and peripheral capsule preserved (PCP) group. The main indicator was intraocular pressure (IOP) at each time point.

Research results

There was no significant difference in IOP among the three groups at any other time point, but five eyes had IOP higher than 30 mmHg, and one eye in the WCP group appeared to have silicone oil entering the anterior chamber. With IOL implantation, the surgery time of the PCP and WCP groups was significantly shorter than that of the AC group, and the incidence rate of posterior capsule opacity was higher in the WCP group than in any other groups. In the CA group, IOL deviation due to suture relaxation occurred in one case.

Research conclusions

Peripheral capsule preserved in vitrectomy combined with lens removal for treatment of severe fundus diseases is an effective method, which can prevent silicone oil from entering the anterior chamber, maintain normal intraocular pressure, facilitate secondary IOL implantation, and reduce intraoperative and postoperative complications.

Research perspectives

In vitrectomy combined with cataract surgery, different capsular preserved status plays different roles in the occurrence of postoperative complications and secondary surgery. Preserving the peripheral capsular can reduce the incidence of postoperative complications and the difficulty of IOL implantation.