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Comment on: ‘Silicone oil residual after vitrectomy for rhegmatogenous retinal detachment’

Eye (2024)Cite this article

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We went through the article titled “Silicone oil residual after vitrectomy for rhegmatogenous retinal detachment” by Zhao et al. [1]. This is a well conducted study providing vitreo-retinal surgeons with a new insight regarding residual silicon oil following vitrectomy. We have a few queries for the authors. It is well known that silicon oil emulsification increases with increasing duration of silicon oil in-situ. Usually, when there is extensive emulsification, emulsified silicon oil droplets enter into the anterior chamber and form an inverse hypopyon in the anterior chamber [2]. In such cases, with emulsified oil in the anterior chamber, an anterior chamber wash is needed, and multiple fluid air exchanges are required to remove as much of the emulsified oil as possible. In the surgical methods described by authors, following active suction, passive drainage of remnant oil was done using a back-flush flute needle inserted into the vitreous cavity. Such a technique will not help in complete removal of oil in those cases where the silicon oil is excessively emulsified. It will be interesting to know how many patients had emulsified oil in anterior chamber at the time of silicon oil removal.

In the ultrasound method described, the probe was placed on the temporal sclera and the nasal part of vitreous cavity was scanned. Silicon oil and its emulsified droplets tend to migrate superiorly due to lower specific gravity. We feel placing the probe on the inferior sclera and scanning the superior vitreous cavity will help quantifying a greater amount of residual silicon oil. We would also like to know whether a higher silicon oil index in a patient who has developed ocular hypertension following vitrectomy warrants performing a vitreous lavage and or anterior chamber wash to flush out the residual silicon oil?

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References

  1. Zhao H, Cheng T, Wu K, Yu J, Zong Y, Chen Q, et al. Silicone oil residual after vitrectomy for rhegmatogenous retinal detachment. Eye. 2023;37:1829–33.

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  2. Light DJ. Silicone oil emulsification in the anterior chamber after vitreoretinal surgery. Optometry. 2006;77:446–9.

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  1. Department of Ophthalmology, Institute of Medical Sciences & SUM Hospital, Siksha O Anusandhan (deemed to be) University, 8-Kalinga Nagar, Bhubaneswar, 751003, India

    Pradeep Kumar Panigrahi

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  1. Pradeep Kumar Panigrahi
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Correspondence to Pradeep Kumar Panigrahi.

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Panigrahi, P.K. Comment on: ‘Silicone oil residual after vitrectomy for rhegmatogenous retinal detachment’. Eye (2024). https://doi.org/10.1038/s41433-024-02941-5

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