03/10/2020
https://www.euretina.org/congress/amsterdam-2020/virtual-2020-freepapers/
Foldable capsular vitreous body: surgical solution for prephthisical eye
Vitreoretinal Surgery Session
Presenting Author: S. Skhirtladze Georgia
Co. Author(s):
M. Dvali
N. Tavberidze
O. Tsertsvadze
G. Mekvabishvili
M. Mtvarelishvili
Purpose:
To report a surgical procedure and the outcome of foldable capsular vitreous body implantation in patient with prephthisical eye with chronic retinal and uveal detachment.Setting:
Clinical case report
Methods:
35 years old male patient had the history of chronic retinal detachment since childhood. no light perception and sensory exotropia was noted. The IOP was 0 mmHg. On slit lamp examination 360 degrees of posterior synechia, iridodonesis and crystalline lens opacification was discovered. B-scan showed total retinal detachment and sectorial choroidal effusion. Ultrasound biomicroscopy demonstrated choroidal effusion with partial cilliary body detachment. In order to support and maintain the eyeball, total retinectomy and FCVB implantation was planned. Surgical synechialysis was performed and iris was expended using iris hooks. AC maintainer was utilzed to support phacoemulsification procedure. 23 gauge chandelier assisted pars plana vitrectomy was done. 360 endodiathermy was performed and was proceeded with total retinectomy. Fluid-air exchange was done. 6 mm scleral incision was made 3.4 mm from the limbus and prefolded FCVB device was introduced through scleral incision. 8.0 Nylon was used to suture wound and to ligate FCVB tube. 23 G VFC silicone oil injection system was utilized to facilitate oil delivery to the FCVB device. After FCVB became sufficiently filled with a silicone oil, the tube was placed in sub-Tenon’s pocket superotemporaly. Surgical iridectomy was made at 12 o clock position.
Results:
Immediate postoperative complication was hyphema (“8 ball”) and was managed in first postoperative week. At the 6-months follow-up, ultrasound (B SCAN) and UBM demonstrated choroidal and cilliary body reatechment . Stable (9-10 mmHg) intraocular pressure was achieved. FCVB showed excellent biocompatibility and stable positioning within the eye.
Conclusions:
Patients with prephthisical eyes with cilliary body detachment and chronic retinal detachments are usually treated with vitrectomy with high viscosity silicone oil tamponade. Vast majority of these patients still need frequent silicone oil exchange and carry high risk of post surgical complications, eventually leading to loss of the eyeball. Silicone oil-filled FCVB implantation has shown to be effective and safe procedure in our case as a vitreous substitute over a 6 month observation period. No tip protrusion was detected. Postoperative intraocular pressure remained stable ( 10 mmHg) during follow up time. More observation is needed to learn long term safety profile .
Financial Disclosure:
NoneFoldable capsular vitreous body: surgical solution for prephthisical eye
Vitreoretinal Surgery Session
Presenting Author: S. Skhirtladze Georgia
Co. Author(s):
M. Dvali
N. Tavberidze
O. Tsertsvadze
G. Mekvabishvili
M. Mtvarelishvili
Purpose:
To report a surgical procedure and the outcome of foldable capsular vitreous body implantation in patient with prephthisical eye with chronic retinal and uveal detachment.
