Transconjunctival 25-gauge sutureless vitrectomy and silicone oil injection in diabetic tractional retinal detachment

Retina. 2008 Oct;28(9):1201-6. doi: 10.1097/IAE.0b013e3181853d3c.

Abstract

Purpose: The purpose of this article was to evaluate the outcomes and complications of transconjunctival sutureless 25-gauge vitrectomy using silicone oil tamponade in diabetic tractional retinal detachment.

Materials and methods: Patients were retrospectively evaluated. Main outcome measure was the feasibility of pars plana vitrectomy and silicone oil injection with 25-gauge system in eyes with diabetic tractional retinal detachment.

Results: Fourteen eyes of 14 patients were included in the study. Tractional retinal detachment was accompanied by vitreous hemorrhage in 9 eyes and combined traction/rhegmatogenous retinal detachment was present in 1 eye. All patients underwent transconjunctival sutureless 25-gauge vitrectomy and 1,000 centistokes silicone oil injection. Angled insertion of the trocars was made in all eyes. Bimanual surgery was performed in 6 (42.8%) eyes. The median preoperative best-corrected visual acuities were 3.00 logarithm of the minimum angle of resolution; it increased to 1.60 logarithm of the minimum angle of resolution at last visit. Retinal tear formation occurred in 4 (28.5%) eyes. Retinal detachment developed in 2 (14.2%) eyes. Intraocular pressure of 5 mmHg or less was detected in 3 (21.4%) eyes. One patient lost light perception due to anterior hyaloidal fibrovascular proliferation.

Conclusion: Pars plana vitrectomy and 1,000 centistokes silicone oil injection with 25-gauge system is feasible in diabetic tractional retinal detachment even in complex cases. Indications of 25-gauge surgery may be expanded toward this area.

MeSH terms

  • Adult
  • Aged
  • Conjunctiva / surgery*
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / physiopathology
  • Diabetic Retinopathy / surgery*
  • Feasibility Studies
  • Female
  • Humans
  • Injections
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Retinal Detachment / complications
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery*
  • Retinal Perforations / complications
  • Retinal Perforations / etiology
  • Retrospective Studies
  • Silicone Oils / administration & dosage*
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy / adverse effects
  • Vitrectomy / instrumentation*
  • Vitrectomy / methods*
  • Vitreous Hemorrhage / complications

Substances

  • Silicone Oils