Comparison of Silicone Oil Removal Using 23-Gauge and 20-Gauge System for Pars Plana Vitrectomy

Dong Ho Chang; Eung Suk Kim; Seung Young Yu; Hyung Woo Kwak

doi:10.3341/jkos.2008.49.12.1929

Journal List > J Korean Ophthalmol Soc > v.49(12) > 1008156

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Chang, Kim, Yu, and Kwak: Comparison of Silicone Oil Removal Using 23-Gauge and 20-Gauge System for Pars Plana Vitrectomy

Original Article

J Korean Ophthalmol Soc 2008;49(12):1929-1934.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.12.1929

Comparison of Silicone Oil Removal Using 23-Gauge and 20-Gauge System for Pars Plana Vitrectomy

Dong Ho Chang, M.D., Eung Suk Kim, M.D., Seung Young Yu, M.D., Hyung Woo Kwak, M.D.

Department of Ophthalmology, KyungHee University College of Medicine, Seoul, Korea

Address reprint requests to Hyung Woo Kwak, M.D. Department of Ophthalmology, KyungHee University College of Medicine #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340, E-mail: hwkwak@khmc.or.kr

Received 19 August 2008 Accepted 2 May 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to compare the clinical results of silicone oil removal using a 23-gauge transconjunctival sutureless pars plana vitrectomy (TSVS) and the 20-gauge pars plana vitrectomy (PPV) system and to evaluate the clinical value of 23-guage PPV system in silicone oil removal.

Methods

Eight eyes of 8 patients who received removal of silicone oil using the 23-gauge TSVS and 6 eyes of 6 patients using the 20-gauge PPV system were included in this study. The total operation time, silicone oil removal time, intraoperative and postoperative advantages, shortcomings, and complications were compared.

Results

The operation time and silicone oil removal time were 44.6±14.1 minutes, 42.7±10.5 minutes and 2.0±0.9 min/cc, 1.4±0.6 min/cc when silicone oil removal was performed using 23-gauge TSVS and 20-gauge PPV system, respectively. They were not significantly different ( p=0.80, 0.22). Attention for the complete removal of the oil is necessary because of the intraocular trocar length when the 23-gauge TSVS is used. There were no complications except transient hypotonies (2 eyes), transient hypertonies (2 eyes) in the 23-gauge system and transient hypertonies (2 eyes) in the 20-gauge system.

Conclusions

The operation time for silicone oil removal using the 23-gauge TSVS was not different than that of the 20-gauge PPV system and can be performed safely without any particular complications. Care and precautionary measures are needed in order to remove silicone oil completely.

Keywords: 20-gauge pars plana vitrectomy (PPV) system, 23-gauge transconjunctival sutureless pars plana vitrectomy (TSVS), Silicone oil removal

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Figure 1

. The photograph of silicone removal using 23-gauge vitrectomy system in a patient with proliferative diabetic retinopathy patient.

Figure 2

. Shortcoming of silicone removal using 23-gauge vitrectomy system (A) compared with 20-gauge vitrectomy system (B). In 23-gauge system, we need some attentions to remove silicone oil completely because of the intraocular trocar length but we can remove oil nearly completely by pulling the needle in 20-gauge system.

Table 1.

Characteristics of patients of silicone oil removal using 23-gauge transconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system

	Silicone oil removal using 23-gauge TSVS∗ patient	Silicone oil removal using 20-gauge VS^† patient	p-value^‡
Male:Female	3:5	1:5
Age (years)	49.75±19.52	50.17±12.29	1
Injected silicone oil volume (cc)	4.63±1.07	4.5±0.43	0.79

^∗ TSVS=transconjunctival sutureless vitrectomy system;

^† VS=vitrectomy system;

^‡ by Mann-Whitney U test.

Table 2.

The mean operation time, silicone removal/injection time of patient silicone oil removal using 23-gauge transconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system

	Silicone oil removal using 23-gauge TSVS∗ patient	Silicone oil removal using 20-gauge VS^† patient	p-value^‡
Mean operation time (min)	44.6±14.1	42.7±10.5	0.80
Siicone oil removal time (min/cc)	2.0±0.9	1.4±0.6	0.22

^∗ TSVS=transconjunctival sutureless vitrectomy system;

^† VS=vitrectomy system

^‡ by Mann-Whitney U test.

Table 3.

The mean preoperative, postoperative 1-day, 1-week, 1-month intraocular pressure after silicone oil removal using 23-gauge transconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system

IOP (mmHg)	Silicone oil removal using 23-gauge TSVS∗ patient	Silicone oil removal using 20-gauge VS^† patient	p-value^‡
IOP (mmHg)	Silicone oil removal using 23-gauge TSVS∗ patient	Silicone oil removal using 20-gauge VS^† patient	p-value^‡	Preoperative	15.9±8.5	17.2±7.5	0.52
Postoperative 1day	12.2±5.8	18.7±2.9	0.03
Postoperative 1 week	14.0±5.9	12.5±3.4	0.79
Postoperative 1 month	11.6±5.1	19.4±8.8	0.10

^∗ TSVS=transconjunctival sutureless vitrectomy system

^† VS=vitrectomy system

^‡ by Mann-Whitney U test.

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