Efficacy evaluation of active silicone oil removal with a sutureless transconjunctival vitrectomy system through partial fluid-air exchange in clinical practice
Objective To investigate the curative effect,timeliness,and safety of active silicone oil(SO)re-moval with a 23-gauge(G)sutureless transconjunctival vitrectomy system through partial fluid-air exchange.Methods A retrospective case-control study.From December 2020 to January 2022,53 siliconized eyes underwent SO removal with two different techniques in the affiliated Shuyang Hospital of Xuzhou Medical University.They were divided into the modified-technique group(Group A,27 eyes)and the traditional-technique group(Group B,26 eyes).Both techniques first made two 23G sclerotomies,with an inferior-temporal cannula for infusion and a superior-temporal cannula for SO removal.Sub-sequently,the operator partially replaced the infused fluid with sterilized air and no suturing was done in group A,while direct removal of the infusion cannula followed by 8-0 suturing of the incision was done in group B.Statistical analyses were performed in terms of operative time,intraocular pressure(IOP)and best-corrected visual acuity(BCVA)before and 1 day,7 days and 1month after the surgery,and adverse responses including subconjunctival hemorrhage,foreign body sen-sation,and intraoperative and postoperative complications were also evaluated.Results SO was removed successfully in all patients with no intraoperative complication.There was no statistical difference between two groups in terms of SO re-moval time,IOP,and BCVA(all P>0.05).Group A exhibited significantly shorter surgery time than Group B(P<0.001),and reduced subconjunctival hemorrhage.The postoperative foreign body sensation evaluation 1 day,7 days,and 1 month in Group A were also significantly lower than that in Group B,respectively(all P<0.001).Besides,in Group B,the percentage of subconjunctival hemorrhage was 46.2%and 3 eyes exhibited vitreous floaters(11.5%)postoperatively while the percentage of subconjunctival hemorrhage was 11.1%and none of the postoperative complications were observed in Group A.Conclusions Active SO removal with a 23G sutureless transconjunctival vitrectomy system through partial fluid-air exchange is a potential modified technique for reducing subconjunctival hemorrhage and postoperative discomfort with satisfying effectiveness and safety,which is worth wider application in clinical practice.
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