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AIM: To study the causes and treatment of silicone oil migration into anterior chamber in phakic eyes after vitrectomy surgery. METHODS: Nineteen patients suffering from retinal detachment underwent vitrectomy combined with silicone oil temponade. A retrospective analysis of silicone oil migration into the anterior chamber in phakic eyes after surgery was carried out, and different measures were taken according to the causes and severity of occurrence. RESULTS: Silicone oil migration into the anterior chamber occurred during second scleral buckling in two eyes. Seventeen cases (19 eyes) manifested with postoperative oil migration into the anterior chamber between two and 11 days, one of which developing to pupil-block glaucoma for oil migration into the anterior chamber again was released by oil removing and peripheral iridectomy at six-o'clock position. Thirteen cases combined with secondary glaucoma were treated by peripheral iridectomy at six-o'clock position, and the silicon oil was removed from the anterior chamber in one week. Postoperatively, intraocular pressure (IOP) was completely controlled below 20 mmHg. Visual acuity regained to previous level in 74% cases and 26% patients had corneal complication after operation, but no one had retinal detachment. CONCLUSION: The causes of silicone oil migration into anterior chamber in phakic eyes after vitrectomy surgery are the damage or relaxation of zonules caused by ocular trauma, high myopia and latrogenic injury during operations. When silicone oil migrates into anterior chamber in phakic eyes after vitrectomy surgery, it is necessary to conduct prone position, observe cornea and remove the oil at early stage. Peripheral iridectomy at six o'clock in patients with pupil block glaucoma is essential to protect cornea, retina and effective visual acuity. LA: Chinese
Dr. J. Zhang, Department of Ophthalmology, People's Hospital of Shaanxi Province, Xi'an 710068 Shaanxi Province, China. drzhj@126.com
9.4.11.5 Glaucomas associated with vitreoretinal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)