Sulcus-to-sulcus suture technique offers solution for silicone oil use in aphakic eyes with iris loss
Take-home message: Placement of “silicone oil retention sutures” sulcus to sulcus in the iris plane in a variety of geometric patterns provides an effective method for keeping the oil out of the anterior chamber.
New York—Silicone oil is commonly used as a long-term intraocular tamponade, and can be a retina specialist’s best friend. In eyes with retinal injury secondary to severe trauma with associated iris loss, however, the use of silicone oil can become surgeon’s worst enemy, said Ronald C. Gentile, MD.
In aphakic eyes with iris loss, placement of 10-0 polypropylene (Prolene, Ethicon) sutures across the anterior chamber from sulcus to sulcus, simulating the iris diaphragm, is an effective method for preventing silicone oil from entering the anterior chamber, said Dr. Gentile, professor of ophthalmology, Icahn School of Medicine at Mount Sinai, and director of the Ocular Trauma Service (posterior segment) and surgeon director, The New York Eye and Ear Infirmary, New York.
Dr. Gentile and Dean Eliott, MD, first described the technique for creating these “silicone oil retention sutures” and its success in a paper [Arch Ophthalmol. 2010;128:1596-1599]. The report presented three cases and used high-frequency ultrasound biomicroscopy to document the ability of the sutures to prevent silicone oil-corneal touch.
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