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Evaluation of Corneal Endothelial Changes in Eyes with Silicone Oil Tamponade After Pars Plana Vitrectomy with or Without Phacoemulsification

Received: 7 April 2022     Accepted: 2 May 2022     Published: 7 May 2022
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Abstract

Aim: To assess corneal endothelium changes by non-contact specular microscopy in eyes underwent pars plana vitrectomy (PPV) with temporary silicone oil (SO) tamponade with or without phacoemulsification. Methods: We concluded 24 patients, divided to two groups: 12 patients had pars plana vitrectomy with SO injection (group 1) and 12 patients had combined phaco-vitrectomy with SO injection (group 2). All of them underwent full ophthalmological examination: best corrected visual acuity (BCVA), measurement of IOP, fundus examination and specular microscopy follow ups at the 1st week, 1st month and 3rd month visits. Results: The count of Endothelial cell density (ECD) in group 1 dropped from 2543.58 ± 759.62 cell/mm2, to 2299.33 ± 729.87 cell/mm2, while in group 2 was 2621.08 ± 514.50, dropped to 2307.50 ± 575.55 respectively, and the mean cell density (MCD) decreased significantly in group 1 and group 2, at 3rd month than at 1st week. Three months after operation, CV (polymegathism) was 34.58 ± 4.29% and 35.75 ± 4.16%, hexagonality (pleomorphism) was 46.83 ± 8.67% and 47.83 ± 10.50%, while mean CCT was 553.08 ± 22.13 μm and 548.17 ± 33.12 for group 1 and 2 respectively, and without corneal edema reported at the study end. Conclusion: pleomorphism (decreased HEX), polymegathism (increased CV) and endothelial cell (EC) loss were documented in all patients underwent pars plana vitrectomy (PPV) with silicone oil (SO) injection with a higher probability of polymegathism (CV increase) noted after adding phacoemulsification to the procedure. These findings strongly suggest early SO removal after reaching aimed tamponading action to avoid SO keratopathy.

Published in International Journal of Ophthalmology & Visual Science (Volume 7, Issue 2)
DOI 10.11648/j.ijovs.20220702.12
Page(s) 51-56
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Keratopathy, Silicon Tamponade, Phacovitrectomy, Corneal Endothelial Cells

References
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[5] Joussen AM and Wong D. “The concept of heavy tamponades—chances and limitations,” Graefe's Archive for Clinical and Experimental Ophthalmology, 2008; 246 (9): 1217–1224.
[6] Ryan JS. “Silicone oils: physicochemical properties,” in Retina, vol. 3, pp. 2191–2210, Elsevier Mosby, 4th edition, 2006.
[7] Beekhuis WH, van Rij G, Zivojnovic R. Silicone oil in the anterior chamber of the eye. Arch Ophthalmol 1986; 104: 793–794.
[8] Huang J, Maram J, Tepelus TC, Modak C, Marion K, Sadda SR, Chopra V, Lee OL. Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy. Journal of optometry. 2018; 11 (3): 182-91.
[9] Toklu E, Altinisik M, Elbay A, Koytak A. Comparison of postoperative anterior segment changes associated with pars plana vitrectomy with and without vitreous base shaving. International Journal of Ophthalmology. 2020; 13 (11): 1745.
[10] Goezinne, Fleur, Rudy M. Nuijts, Albert T. Liem, Igor J. Lundqvist, Tos J. Berendschot, Diana W. Cals, Fred Hendrikse, and Ellen C. La Heij. "Corneal Endothelial Cell Density After Vitrectomy With Silicone Oil for Complex Retinal Detachments" Retina, 2013.
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[13] Koushan K, Mikhail M, Beattie A, Ahuja N, Liszauer A, Kobetz L, Farrokhyar F, Martin JA. Corneal endothelial cell loss after pars plana vitrectomy and combined phacoemulsification–vitrectomy surgeries. Canadian Journal of Ophthalmology. 2017; 52 (1): 4-8.
[14] Muslim I, Khan AA, Chaudhry N. Anatomical and visual outcome of combined phaco-vitrectomy vs vitrectomy alone. Pakistan Postgraduate Medical Journal. 2020; 31 (04): 204-9.
[15] Yorgun MA, Toklu Y, Mutlu M, Ozen U. Clinical outcomes of 25-gauge vitrectomy surgery for vitreoretinal diseases: comparison of vitrectomy alone and phaco-vitrectomy. International journal of ophthalmology. 2016; 9 (8): 1163.
[16] Michael A. Kass, Dale K. Heuer, Eve J. Higginbotham, et al. The Ocular Hypertension Treatment Study Randomized Trial Determines That Topical Ocular Hypotensive Medication Delays or Prevents the Onset of Primary Open-Angle Glaucoma Arch Ophthalmol. 2002; 120 (6): 701-713.
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Cite This Article
  • APA Style

    Mohamed A. M. R. Afify, Ahmed H. Assaf, Raafat Ali Rehan, Hazem Abdallah Elnashar, Marwa A. Karim. (2022). Evaluation of Corneal Endothelial Changes in Eyes with Silicone Oil Tamponade After Pars Plana Vitrectomy with or Without Phacoemulsification. International Journal of Ophthalmology & Visual Science, 7(2), 51-56. https://doi.org/10.11648/j.ijovs.20220702.12

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    ACS Style

    Mohamed A. M. R. Afify; Ahmed H. Assaf; Raafat Ali Rehan; Hazem Abdallah Elnashar; Marwa A. Karim. Evaluation of Corneal Endothelial Changes in Eyes with Silicone Oil Tamponade After Pars Plana Vitrectomy with or Without Phacoemulsification. Int. J. Ophthalmol. Vis. Sci. 2022, 7(2), 51-56. doi: 10.11648/j.ijovs.20220702.12

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    AMA Style

    Mohamed A. M. R. Afify, Ahmed H. Assaf, Raafat Ali Rehan, Hazem Abdallah Elnashar, Marwa A. Karim. Evaluation of Corneal Endothelial Changes in Eyes with Silicone Oil Tamponade After Pars Plana Vitrectomy with or Without Phacoemulsification. Int J Ophthalmol Vis Sci. 2022;7(2):51-56. doi: 10.11648/j.ijovs.20220702.12

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  • @article{10.11648/j.ijovs.20220702.12,
      author = {Mohamed A. M. R. Afify and Ahmed H. Assaf and Raafat Ali Rehan and Hazem Abdallah Elnashar and Marwa A. Karim},
      title = {Evaluation of Corneal Endothelial Changes in Eyes with Silicone Oil Tamponade After Pars Plana Vitrectomy with or Without Phacoemulsification},
      journal = {International Journal of Ophthalmology & Visual Science},
      volume = {7},
      number = {2},
      pages = {51-56},
      doi = {10.11648/j.ijovs.20220702.12},
      url = {https://doi.org/10.11648/j.ijovs.20220702.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20220702.12},
      abstract = {Aim: To assess corneal endothelium changes by non-contact specular microscopy in eyes underwent pars plana vitrectomy (PPV) with temporary silicone oil (SO) tamponade with or without phacoemulsification. Methods: We concluded 24 patients, divided to two groups: 12 patients had pars plana vitrectomy with SO injection (group 1) and 12 patients had combined phaco-vitrectomy with SO injection (group 2). All of them underwent full ophthalmological examination: best corrected visual acuity (BCVA), measurement of IOP, fundus examination and specular microscopy follow ups at the 1st week, 1st month and 3rd month visits. Results: The count of Endothelial cell density (ECD) in group 1 dropped from 2543.58 ± 759.62 cell/mm2, to 2299.33 ± 729.87 cell/mm2, while in group 2 was 2621.08 ± 514.50, dropped to 2307.50 ± 575.55 respectively, and the mean cell density (MCD) decreased significantly in group 1 and group 2, at 3rd month than at 1st week. Three months after operation, CV (polymegathism) was 34.58 ± 4.29% and 35.75 ± 4.16%, hexagonality (pleomorphism) was 46.83 ± 8.67% and 47.83 ± 10.50%, while mean CCT was 553.08 ± 22.13 μm and 548.17 ± 33.12 for group 1 and 2 respectively, and without corneal edema reported at the study end. Conclusion: pleomorphism (decreased HEX), polymegathism (increased CV) and endothelial cell (EC) loss were documented in all patients underwent pars plana vitrectomy (PPV) with silicone oil (SO) injection with a higher probability of polymegathism (CV increase) noted after adding phacoemulsification to the procedure. These findings strongly suggest early SO removal after reaching aimed tamponading action to avoid SO keratopathy.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Evaluation of Corneal Endothelial Changes in Eyes with Silicone Oil Tamponade After Pars Plana Vitrectomy with or Without Phacoemulsification
    AU  - Mohamed A. M. R. Afify
    AU  - Ahmed H. Assaf
    AU  - Raafat Ali Rehan
    AU  - Hazem Abdallah Elnashar
    AU  - Marwa A. Karim
    Y1  - 2022/05/07
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijovs.20220702.12
    DO  - 10.11648/j.ijovs.20220702.12
    T2  - International Journal of Ophthalmology & Visual Science
    JF  - International Journal of Ophthalmology & Visual Science
    JO  - International Journal of Ophthalmology & Visual Science
    SP  - 51
    EP  - 56
    PB  - Science Publishing Group
    SN  - 2637-3858
    UR  - https://doi.org/10.11648/j.ijovs.20220702.12
    AB  - Aim: To assess corneal endothelium changes by non-contact specular microscopy in eyes underwent pars plana vitrectomy (PPV) with temporary silicone oil (SO) tamponade with or without phacoemulsification. Methods: We concluded 24 patients, divided to two groups: 12 patients had pars plana vitrectomy with SO injection (group 1) and 12 patients had combined phaco-vitrectomy with SO injection (group 2). All of them underwent full ophthalmological examination: best corrected visual acuity (BCVA), measurement of IOP, fundus examination and specular microscopy follow ups at the 1st week, 1st month and 3rd month visits. Results: The count of Endothelial cell density (ECD) in group 1 dropped from 2543.58 ± 759.62 cell/mm2, to 2299.33 ± 729.87 cell/mm2, while in group 2 was 2621.08 ± 514.50, dropped to 2307.50 ± 575.55 respectively, and the mean cell density (MCD) decreased significantly in group 1 and group 2, at 3rd month than at 1st week. Three months after operation, CV (polymegathism) was 34.58 ± 4.29% and 35.75 ± 4.16%, hexagonality (pleomorphism) was 46.83 ± 8.67% and 47.83 ± 10.50%, while mean CCT was 553.08 ± 22.13 μm and 548.17 ± 33.12 for group 1 and 2 respectively, and without corneal edema reported at the study end. Conclusion: pleomorphism (decreased HEX), polymegathism (increased CV) and endothelial cell (EC) loss were documented in all patients underwent pars plana vitrectomy (PPV) with silicone oil (SO) injection with a higher probability of polymegathism (CV increase) noted after adding phacoemulsification to the procedure. These findings strongly suggest early SO removal after reaching aimed tamponading action to avoid SO keratopathy.
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Memorial Institute for Ophthalmic Research (MIOR), Cairo, Egypt

  • Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

  • Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

  • Memorial Institute for Ophthalmic Research (MIOR), Cairo, Egypt

  • Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

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