Surgical Management for Silicone Oil Barrier of Traumatic Aniridia with Aphakia: Suturing of Temporary Iris-Diaphragm Prior to Final Iris-Lens-Diaphragm Implantation

Overview

Journal Clin Ophthalmol

Publisher Dove Medical Press

Specialty Ophthalmology

Date 2020 Dec 30

PMID 33376298

Citations 7

Authors

Christian S Mayer

Isabella Baur

Julia Storr

Alexander Markard

Ramin Khoramnia

Affiliations

Soon will be listed here.

Abstract

Purpose: Patients with traumatic aniridia, aphakia and retinal complications can require silicone oil endotamponade. In the absence of compartmentalization, there is a risk of silicone oil migrating to the anterior chamber which can cause long-term complications. We report a two-step procedure in trauma cases, using sutures for silicone oil retention in primary care and subsequently prior to secondary artificial iris (AI) and intraocular lens (IOL) implantation, to achieve a reconstruction of the anterior and posterior chamber.

Material And Methods: Seven patients with loss of the iris-lens-diaphragm after an ocular trauma and the need for silicone oil endotamponade underwent a primary intervention including wound closure, placement of silicone oil retention sutures and silicone oil filling. Four of those underwent secondary reconstruction with silicone oil removal and AI and IOL implantation and could be included in this retrospective observational study. All main outcome measures were evaluated after the first and after the second surgery. The main outcome measures were morphological findings, subjective impairment from glare, subjective cosmetic disfigurement, patient satisfaction and intraocular pressure (IOP) as well as best-corrected distance visual acuity and objective refraction.

Results: The retention sutures could effectively prevent silicone oil migration into the anterior chamber in the first surgery. Silicone oil emulsifications in the anterior chamber were observed in one patient. In two patients, pigment deposition at the sutures was seen. Subjective impairment from glare and subjective cosmetic disfigurement could be reduced after the second surgery compared to the evaluation after the first surgery. IOP and best-corrected distance visual acuity remained stable. No eye needed silicone oil refilling after the secondary reconstruction surgery.

Conclusion: Our two-step approach is viable and provides good functional and aesthetic results. We observed a high patient satisfaction.

Citing Articles

Combined Penetrating Keratoplasty and Vitrectomy: Long-Term Follow-Up Results.

Vidne-Hay O, Alhalel A, Barequet I J Clin Med. 2024; 13(23).

PMID: 39685926 PMC: 11641849. DOI: 10.3390/jcm13237468.

The Double-Deck Viscoelastic Technique: a Novel Surgical Technique to Protect the Corneal Endothelium in Penetrating Keratoplasty of Aphakic Silicone Oil-Dependent Eyes after Severe Ocular Injury.

Cen Y, Zhang M, Lu Y, Feng Y Ophthalmol Ther. 2022; 12(1):613-623.

PMID: 36309624 PMC: 9834487. DOI: 10.1007/s40123-022-00594-9.

Open Globe Injuries: Classifications and Prognostic Factors for Functional Outcome.

Mayer C, Reznicek L, Baur I, Khoramnia R Diagnostics (Basel). 2021; 11(10).

PMID: 34679549 PMC: 8534971. DOI: 10.3390/diagnostics11101851.

[Pupil reconstruction with an artificial iris].

Mayer C, Khoramnia R Ophthalmologe. 2021; 119(1):3-12.

PMID: 34181062 PMC: 8763738. DOI: 10.1007/s00347-021-01406-4.

Bilateral Artificial Iris implantation in patients with bilateral iris defects.

Mayer C, Baur I, Storr J, Khoramnia R Am J Ophthalmol Case Rep. 2021; 22:101108.

PMID: 34027229 PMC: 8121880. DOI: 10.1016/j.ajoc.2021.101108.

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