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    Tool allows cataract extraction, IOL implantation, silicone oil removal in one-stage procedure

    Reusable cannula designed to both stent open temporal cataract wound to allow egress, aspirate oil

    Take-home message: A new instrument can be used during cataract surgery to remove silicone oil placed in the vitreous cavity during prior surgery for complicated retinal detachment.

    Reviewed by Lawrence R. Goldberg, MD

    Saint Petersburg, FLUsing a new instrument (Goldberg Silicone Oil Extractor, Rhein Medical), cataract surgeons can perform a one-stage procedure for cataract extraction, IOL implantation, and silicone oil removal.

    This is contrasted with a two-stage procedure of first having the retinal surgeon extract the silicone oil, and at a future date, having the cataract surgeon remove the cataract and implant the IOL.

    The two-stage procedure is less desirable since it requires two separate operating room sessions, is more costly, and lengthens the visual rehabilitation of the patient, said Lawrence R. Goldberg, MD, an ophthalmologist in private practice in Saint Petersburg, FL, who designed the tool in collaboration with Rhein Medical.

    The instrument is a reusable cannula designed to both stent open the temporal cataract wound to allow egress of the silicone oil out of the eye and aspirate any residual oil that remains in the vitreous cavity. Dr. Goldberg said.

    A significant oil bubble remains in about 1/3 of cases, resistant to removal by irrigation through the sideport incision, ultimately requiring controlled aspiration utilizing the new cannula.

    In the one-stage surgical procedure, after cataract removal and posterior capsulorhexis, a 23-gauge anterior chamber maintainer is inserted through the sideport incision, and in the majority of cases the oil is removed after it floats on top of the balanced salt solution (BSS) and out the stented temporal wound.

    In some patients, a substantial oil bubble remains in the posterior chamber that will not float through the posterior capsulorhexis and out the main incision regardless of the patient's head position. These are the cases for which the new cannula is especially beneficial.

    Extracting resistant oil bubbles

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