Analysis of silicone oil emulsification and related factors in eyes filled with silicone oil for rhegmatogenous retinal detachment_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhao Hongmei , Yu Jian , Wu Kaicheng , Zong Yuan ,  Jiang Chunhui , Xu Gezhi

Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai 200031, ChinaZhao Hongmei and Yu Jian are contributed equally to the article;

Corresponding author：

Jiang Chunhui, Email: chhjiang70@163.com

Keywords：

Retinal detachment; Vitrectomy; Silicone emulsion; Root cause analysis

DOI：

10.3760/cma.j.cn511434-20211130-00671

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Objective To observe the emulsification of silicone oil in eyes with rhegmatogenous retinal detachment (RRD) after silicone oil filling surgery, and to preliminarily analyze the possible clinical factors related to it. Methods A cross-sectional clinical study. From January 2019 to April 2022, 50 eyes of 50 patients with RRD who underwent pans plana vitrectomy (PPV) combined with silicone oil filling surgery in Eye and ENT Hospital of Fudan University were included in the study. Among them, there were 25 males with 25 eyes and 25 females with 25 eyes; the age was 54.86±11.79 years old. The retina was in place 3 months after surgery. Before silicone oil removal surgery, intraocular pressure ＞21 mm Hg (1 mm Hg=0.133 kPa) or treated with≥1 anti-glaucoma drug (high intraocular pressure) in 20 eyes; intraocular pressure ≤21 mm Hg and no anti-glaucoma drug treatment in 30 eyes (normal intraocular pressure). During follow-up after surgery, silicone oil emulsification was found and those who met the indications for silicone oil removal were subjected to silicone oil removal surgery. The first 2 ml of lavage fluid was collected immediately after removal of the silicone oil, and the particle diameter and number of emulsified silicone oil were measured using a Multisizer^® 3 particle/cell counter and particle size analyzer. The measuring range was 0.4-12.0 μm, and the diameter is accordingly divided into 0.4-＜1.0, 1.0-＜3.0, 3.0-＜5.0, 5.0-＜7.0, 7.0-12.0 μm. Each sample was measured 3 times and the average value was taken. Spearman correlation analysis and multiple linear regression analysis were used to analyze the correlation between the number of emulsified silicone oil particles and clinical factors. Results The number of emulsified silicone oil particles was (1.74±2.94)×10⁷/ml (0.96×10⁷-14.11×10⁷/ml), of which the diameter of 0.4-＜1.0 μm emulsified silicone oil particle was (1.25±2.41)×10⁷/ml, accounted for (64.26±12.70)% [(1.25±2.41)×10⁷/(1.74±2.94)×10⁷]. The results of correlation analysis showed that there was no correlation between the total particle number of emulsified silicone oil and various clinical factors (P＞0.05). The number of emulsified silicone oil particles with a diameter of 7.0-12.0 μm was negatively correlated with age (r=－0.298, P=0.036), and positively correlated with axial length (r=0.325, P=0.021). There was no correlation between the previous ocular trauma, choroidal detachment and different lens states and the number of emulsified silicone oil particles (P＞0.05). Multiple linear regression analysis showed that eye axis (β=1 570.868, P=0.023) and age (β=－316.128, P=0.039) were the risk predictors of silicone oil emulsification into large diameter particles (7-＜12 μm). The number of emulsified silicone oil particles with a diameter of 7-12 μmin the patients with high intraocular pressure was significantly higher than that in the patients with normal intraocular pressure, and the difference was statistically significant (U=195.00, P=0.037). Conclusions Most of the emulsified silicone oil particles in the eyes of RRD patients after silicone oil filling surgery are small-diameter particles; the silicone oil emulsification is more serious in young patients and patients with long ocular axis, and young patients are more prone to high intraocular pressure.

Citation： Zhao Hongmei, Yu Jian, Wu Kaicheng, Zong Yuan, Jiang Chunhui, Xu Gezhi. Analysis of silicone oil emulsification and related factors in eyes filled with silicone oil for rhegmatogenous retinal detachment. Chinese Journal of Ocular Fundus Diseases, 2022, 38(10): 818-822. doi: 10.3760/cma.j.cn511434-20211130-00671 Copy

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2.	Ichhpujani P, Jindal A, Jay Katz L. Silicone oil induced glaucoma: a review[J]. Graefe's Arch Clin Exp Ophthalmol, 2009, 247(12): 1585-1593. DOI: 10.1007/s00417-009-1155-x.
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4.	Chan YK, Cheung N, Chan WS, et al. Quantifying silicone oil emulsification in patients: are we only seeing the tip of the iceberg?[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(10): 1671-1675. DOI: 10.1007/s00417-014-2866-1.
5.	Yu J, Zong Y, Jiang C, et al. Silicone oil emulsification after vitrectomy for rhegmatogenous retinal detachment[J/OL]. J Ophthalmol, 2020, 2020: 6940625[2020-02-24]. https://pubmed.ncbi.nlm.nih.gov/32185075/. DOI: 10.1155/2020/6940625.
6.	Zhang W, Hu Y, Choi G, et al. Microfluidic multiple cross-correlated Coulter counter for improved particle size analysis [J/OL]. Sensors and Actuators B: Chemical, 2019, 296: 126615[2019-05-29]. https://www.sciencedirect.com/science/article/pii/S0925400519308044. DOI:10.1016/j.snb.2019.05.092.
7.	Savion N, Alhalel A, Treister G, et al. Role of blood components in ocular silicone oil emulsification. Studies on an in vitro model[J]. Invest Ophthalmol Vis Sci, 1996, 37(13): 2694-2699.
8.	Zhao XJ, Tang NN, Lian Y, et al. Analysis of the rates of emulsification in intraocular silicone oil tamponades of differing viscosities[J]. Int J Ophthalmol, 2020, 13(5): 761-765. DOI: 10.18240/ijo.2020.05.10.
9.	Ni Y, Fang H, Zhang X, et al. Analysis of the causative factors related to earlier emulsification of silicone oil[J]. Int J Ophthalmol, 2019, 12(3): 517-519. DOI: 10.18240/ijo.2019.03.25.
10.	Miller JB, Papakostas TD, Vavvas DG. Complications of emulsified silicone oil after retinal detachment repair[J]. Semin Ophthalmol, 2014, 29(5-6): 312-318. DOI: 10.3109/08820538.2014.962181.
11.	Nepita I, Repetto R, Pralits JO, et al. The role of endogenous proteins on the emulsification of silicone oils used in vitreoretinal surgery[J/OL]. Biomed Res Int, 2020, 2020: 2915010[2020-08-20]. https://pubmed.ncbi.nlm.nih.gov/32904511/. DOI: 10.1155/2020/2915010.
12.	Chan YK, Cheung N, Wong D. Factors influencing the shear rate acting on silicone oil to cause silicone oil emulsification[J]. Invest Ophthalmol Vis Sci, 2014, 55(11): 7451-7456. DOI: 10.1167/iovs.14-14572.
13.	Shiihara H, Terasaki H, Yoshihara N, et al. Amount of residual silicone oil in vitreous cavity is significantly correlated with axial length[J]. Retina, 2016, 36(1): 181-187. DOI: 10.1097/IAE.0000000000000656.
14.	Zhao H, Yu J, Zong Y, et al. Characteristics of silicone oil emulsification after vitrectomy for rhegmatogenous retinal detachment: an ultrasound biomicroscopy study[J/OL]. Front Med (Lausanne), 2022, 8: 794786[2022-01-13]. https://pubmed.ncbi.nlm.nih.gov/35096885/. DOI: 10.3389/fmed.2021.794786.
15.	Oshika T. Aqueous protein concentration in rhegmatogenous retinal detachment[J]. Jpn J Ophthalmol, 1990, 34(1): 63-71.
16.	Yilmaz T, Guler M. The role of nystagmus in silicone oil emulsification after pars plana vitrectomy and silicone oil injection for complex retinal detachment[J]. Eur J Ophthalmol, 2008, 18(1): 150-154. DOI: 10.1177/112067210801800128.
17.	Sampaolesi R. Scanning electron microscopy of the trabecular meshwork in normal and glaucomatous eyes[J]. Invest Ophthalmol Vis Sci, 1977, 14(4): 302-314.

1. Federman JL, Schubert HD. Complications associated with the use of silicone oil in 150 eyes after retina-vitreous surgery[J]. Ophthalmology, 1988, 95(7): 870-876. DOI: 10.1016/s0161-6420(88)33080-0.
2. Ichhpujani P, Jindal A, Jay Katz L. Silicone oil induced glaucoma: a review[J]. Graefe's Arch Clin Exp Ophthalmol, 2009, 247(12): 1585-1593. DOI: 10.1007/s00417-009-1155-x.
3. Le Q, Wang X, Lyv J, et al. In vivo laser scanning confocal microscopy of the cornea in patients with silicone oil tamponade after vitreoretinal surgery[J]. Cornea, 2012, 31(8): 876-882. DOI: 10.1097/ICO.0b013e3182408cef.
4. Chan YK, Cheung N, Chan WS, et al. Quantifying silicone oil emulsification in patients: are we only seeing the tip of the iceberg?[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(10): 1671-1675. DOI: 10.1007/s00417-014-2866-1.
5. Yu J, Zong Y, Jiang C, et al. Silicone oil emulsification after vitrectomy for rhegmatogenous retinal detachment[J/OL]. J Ophthalmol, 2020, 2020: 6940625[2020-02-24]. https://pubmed.ncbi.nlm.nih.gov/32185075/. DOI: 10.1155/2020/6940625.
6. Zhang W, Hu Y, Choi G, et al. Microfluidic multiple cross-correlated Coulter counter for improved particle size analysis [J/OL]. Sensors and Actuators B: Chemical, 2019, 296: 126615[2019-05-29]. https://www.sciencedirect.com/science/article/pii/S0925400519308044. DOI:10.1016/j.snb.2019.05.092.
7. Savion N, Alhalel A, Treister G, et al. Role of blood components in ocular silicone oil emulsification. Studies on an in vitro model[J]. Invest Ophthalmol Vis Sci, 1996, 37(13): 2694-2699.
8. Zhao XJ, Tang NN, Lian Y, et al. Analysis of the rates of emulsification in intraocular silicone oil tamponades of differing viscosities[J]. Int J Ophthalmol, 2020, 13(5): 761-765. DOI: 10.18240/ijo.2020.05.10.
9. Ni Y, Fang H, Zhang X, et al. Analysis of the causative factors related to earlier emulsification of silicone oil[J]. Int J Ophthalmol, 2019, 12(3): 517-519. DOI: 10.18240/ijo.2019.03.25.
10. Miller JB, Papakostas TD, Vavvas DG. Complications of emulsified silicone oil after retinal detachment repair[J]. Semin Ophthalmol, 2014, 29(5-6): 312-318. DOI: 10.3109/08820538.2014.962181.
11. Nepita I, Repetto R, Pralits JO, et al. The role of endogenous proteins on the emulsification of silicone oils used in vitreoretinal surgery[J/OL]. Biomed Res Int, 2020, 2020: 2915010[2020-08-20]. https://pubmed.ncbi.nlm.nih.gov/32904511/. DOI: 10.1155/2020/2915010.
12. Chan YK, Cheung N, Wong D. Factors influencing the shear rate acting on silicone oil to cause silicone oil emulsification[J]. Invest Ophthalmol Vis Sci, 2014, 55(11): 7451-7456. DOI: 10.1167/iovs.14-14572.
13. Shiihara H, Terasaki H, Yoshihara N, et al. Amount of residual silicone oil in vitreous cavity is significantly correlated with axial length[J]. Retina, 2016, 36(1): 181-187. DOI: 10.1097/IAE.0000000000000656.
14. Zhao H, Yu J, Zong Y, et al. Characteristics of silicone oil emulsification after vitrectomy for rhegmatogenous retinal detachment: an ultrasound biomicroscopy study[J/OL]. Front Med (Lausanne), 2022, 8: 794786[2022-01-13]. https://pubmed.ncbi.nlm.nih.gov/35096885/. DOI: 10.3389/fmed.2021.794786.
15. Oshika T. Aqueous protein concentration in rhegmatogenous retinal detachment[J]. Jpn J Ophthalmol, 1990, 34(1): 63-71.
16. Yilmaz T, Guler M. The role of nystagmus in silicone oil emulsification after pars plana vitrectomy and silicone oil injection for complex retinal detachment[J]. Eur J Ophthalmol, 2008, 18(1): 150-154. DOI: 10.1177/112067210801800128.
17. Sampaolesi R. Scanning electron microscopy of the trabecular meshwork in normal and glaucomatous eyes[J]. Invest Ophthalmol Vis Sci, 1977, 14(4): 302-314.

Chinese Journal of Ocular Fundus Diseases

Analysis of silicone oil emulsification and related factors in eyes filled with silicone oil for rhegmatogenous retinal detachment

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