|Year : 1982 | Volume
| Issue : 6 | Page : 583-584
"Intra-vitreal injection of silicone-oil (management of persistent retinal detachmet after multiple) operations."
M M Joshi
"Padmanyanalaya", Gokal Road, Hosur, Hubli 580 021
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Joshi M M. "Intra-vitreal injection of silicone-oil (management of persistent retinal detachmet after multiple) operations.". Indian J Ophthalmol 1982;30:583-4
It is disheartening to note that some cases, of retinal detachment are abandoned as incurable after attempting repeated operations with the conventional methods. This paper presents 6 cases in which retina did not reattach after multiple operations treated within the last two years with intra-vitreal injection of Silicone-Oil as an adjunct to the conventional procedures to achieve the adequate opposition of detached portion of the choroid. Of these, two were children aged 12 years, two were between 35 and 40 years and two elderly patients over 60 years,
All these patients had high myopia of over -8.ODS and one child had associated typical coloboma of iris & choroid in the only eye, the other being phthisis bulbi following a trauma in the past.
Two cases were operated before for retinal detachment twice by me only, and the others had undergone operation elsewhere for 3 times on the same eye before I selected them for intra-vitreal injection of Silicone-oil. All these patients had sub-total detachment of retina and multiple tears situated anterior to the equator.
After he encirclage, Injection of Silicone-Oil DC 20/10000S was carried out by using 5 cc. leur-lock syringe with 2" long 16 gauge needle which was welded to the syringe, to prevent any leak, The Silicome-Oil was filled in the syring the previous day and was sterilised in a hot-air-oven at 150° C for 1 & 12 hours to avoid the entry of the air bubles which invariably happens if the sterilised Silicone-Oil were sucked into syringe at the time of injection.
An incision was made at pars plana and purse string sutures were put. The needle was inserted through this incision under direct observation so as to go as near to the optic disc as possible. Two to 3 ml. oil was injected by the assistant till the retina settled properly, pushing out the subretinal fluid t hrough the incisions already made.
Incisions were closed and encircling intra-ocular band was tightened to restore tension around 20 mm. Hg.
During the early post-operative period, 40 units of A. C. T. H were given on 3rd day, to minimise chemosis that was present. Regular post-operative check-up at the intervals of 2 months has revealed continued re-attachment of retina, the longest period of follow-up being 22 months and the shortest 10 months.
Prior to the operation, all these patients had only good perception of light in all the quadrants. Visual results after the operations are :
Maximum visual acuity
1. F. C. at 10 feet in 2 cases.
2. F. C. at 6 feet in 2 cases and
3. F. C. 1 foot in temporal field only in 2 cases.
The above results of visual recovery may not appear impressive but it is heartening to note that the one-eyed-boy is able to move about and manage himself after this operation.
| Summary|| |
Six cases of persistent retinal detachment after multiple surgery, abandoned as incurable have recovered some vision after intra-vitreal injection of Silicone-Oil as an adjunt to conventional management in retinal detachment surgery.