The use of liquid silicone in retinal detachment surgery.
TL;DR: The present study finds a "viscosity" that would maintain the "clarity" of the vitreous of rabbits and help in "replacing the retina" in plastic surgery and retinal detachment procedures.
Abstract: Introduction Silicone rubber has been widely used as implant material in plastic surgery and in retinal detachment procedures. 1 Liquid silicone was first injected into the vitreous cavity of rabbits by Stone, 2 who reported that silicone fluids of various viscosities were well tolerated and produced "very little change in the rabbit eyes over a period of two years." He went on to predict that it might be possible to find a "viscosity" that would maintain the "clarity" of the vitreous and help in "replacing the retina." Recently, other investigators 3-5 have confirmed Stone's observations. However, their animal experiments emphasized the possibilities of complications. Everett 4 reported cataract formation following the injection of liquid silicone into the vitreous cavity of rabbits; Galavin 5 produced glaucoma by the injection of liquid silicone into the posterior chamber of the rabbit eye. The present study serves a dual purpose: (1) to report further
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TL;DR: The risk of serious adverse events reported after IVT injection is low, Nevertheless, careful attention to injection technique and appropriate postinjection monitoring are essential because uncommon injection-related complications may be associated with permanent vision loss.
Abstract: Purpose:To evaluate the prevalence of the most common serious adverse events associated with intravitreous (IVT) injection.Methods:A systematic search of the literature via PubMed from 1966 to March 1, 2004, was conducted to identify studies evaluating the safety of IVT injection. Data submitted in
527 citations
TL;DR: Without exception, within a period of 1 year the intraocular silicone oil showed some degree of emulsification, suggesting that the physicochemical characteristics of the oil injected may be an important variable in long-term complications.
410 citations
TL;DR: In this article, the authors report anatomic and visual acuity outcomes, as well as complications, after using 1000centistoke silicone oil as a retinal tamponade for the treatment of complex retinal detachments in a pediatric population.
257 citations
TL;DR: Overall, surgery for PVR had a high likelihood of retinal reattachment, and if anatomically and visually successful at 3 years, there is an excellent chance that the results will be maintained over the long-term.
Abstract: Background: The Silicone Study evaluated the outcomes of vitreoretinal surgery for retinal detachment with proliferative vitreoretinopathy (PVR). Objective: To evaluate short-term (up to 36 months) outcomes in eyes randomized to silicone oil or perfluoropropane gas and long-term (up to 72 months) outcomes in eyes with attached maculas at 36 months. Design: Prospective, randomized, multicentered surgical trial. Setting: Community- and university-based vitreoretinal practices. Patients: Two-hundred sixty-five eyes with PVR randomized to perfluoropropane gas and silicone oil with follow-up through 3 years (cohort 1) and 249 eyes with attached maculas at 36 months (121 eyes randomized to long-acting gas [either sulfur hexafluoride or perfluoropropane] and 128 eyes randomized to silicone oil) with follow-up up to 6 years (cohort 2). Both cohorts consisted of eyes that had and had not undergone vitrectomy for PVR (groups 1 and 2, respectively) before randomization. Of the 265 eyes in cohort 1, 24-month follow-up data were available for 218 eyes (82%) and 36-month follow-up data were available for 196 eyes (74%). Of 208 eyes in cohort 2, 48-month follow-up data were available for 146 eyes (70%), 60-month follow-up data for 119 eyes (57%), and 72-month follow-up data for 73 eyes (35%). Interventions: Vitrectomy surgery for PVR with a long-acting gas or silicone oil as the intraocular tamponade. Main Outcome Measures: Changes in visual acuity, recurrent retinal detachment, and incidence of complications. Results: In group 1 of cohort 1, compared with oiltreated eyes, gas-treated eyes had a higher rate of complete retinal reattachment from 18 to 36 months ( P P P =.02). Compared with oil-retained eyes, oil-removed eyes had higher rates of complete posterior attachment ( P =.01) and of a visual acuity of 5/200 or better ( P P P P Conclusion: The Silicone Study showed that silicone oil and perfluoropropane gas were equal in most respects for the management of retinal detachments with PVR. Success in the first surgery for PVR is paramount for obtaining better visual results. Overall, surgery for PVR had a high likelihood of retinal reattachment, and if anatomically and visually successful at 3 years, there is an excellent chance that the results will be maintained over the long-term.
200 citations
TL;DR: Clinical complications directly related to silicone oil were rare and did not progress or develop after the removal of silicone except for opacification of the lens in phakic eyes.
173 citations
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TL;DR: The use of metals and plastics as replacement for function is becoming an important and interesting development in modern surgery.
Abstract: Lid Surgery If the levator of the upper lid is functioning, a ptosis is usually corrected by one of several lid-shortening procedures. If there is partial or complete paresis of the levator, the frontalis muscle can be made to replace levator action. The tarsus is usually attached to the frontalis muscle by various substances. The most popular is fascia lata.22 However, this requires two operative sites and is a fairly long procedure. Buried, braided, waxed silk can also be used for this purpose. The sutures pass under the skin from the free border of the eyelid upward to above the . . .
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Journal Article•
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Journal Article•
TL;DR: Iodide is a useful anion for estimating the coefficient of aqueous flow and requires punctures of the anterior chamber only and can be used in two eyes of one animal, or with the use of two or more isotopes of iodide.
Abstract: Trace amounts of iodide are transported out of the rabbit eye in such a fashion that this union accumulates in the aqueous humor of the anterior chamber exponentially toith time. Iodide is therefore a useful anion for estimating the coefficient of aqueous flow and requires punctures of the anterior chamber only. The method can be used in two eyes of one animal, or with the use of two or more isotopes of iodide, can be applied to a single eye. The iodide methoddemonstrates a floiu coefficient of 1.5 per cent of the anterior chamber per minute in the normal animal. It is reduced by some 45 to 50 per cent following acetazolamide, by 80 to 90 per cent during hypothermia (18 to 20° C), and by an average of 17 per cent on the side of carotid ligation. Topical pilocarpine appears to increase the flow coefficient by an average of 16 per cent and atropine to decrease it by 21 per cent.
30 citations