[ERG findings in patients with intraocular silicone oil filling].
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Electroretinography
Human physiology
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To evaluate the efficacy and safety of silicone oil barrier sutures in aphakic eyes with iris defects.Sixteen aphakic and iris-defective eyes of 16 patients who underwent a pars plana vitrectomy procedure with silicone oil tamponade because of retinal detachment were included in this retrospective study. Silicone oil barrier sutures were placed as a grid pattern within the plane of the previous iris after vitrectomy and before silicone oil injection.The mean follow-up time after silicone oil barrier suture operations was 12.0 ± 6.8 months. Silicone oil was present in the anterior chamber in five eyes (31%) at the last visit. These eyes also had hypotony, band keratopathy, and anterior proliferative vitreoretinopathy.In this study, silicone oil barrier sutures were proven to be safe and effective in preventing silicone oil-corneal endothelium touch in aphakic eyes with iris defects, unless hypotony was present because of anterior proliferative vitreoretinopathy.
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Abstract Keratopathy represents one of the most frequent late complications in eyes with complicated retinal detachment treated with intraocular silicone oil. Corneal examinations including endothelial specular photography were done on 18 silicone treated eyes, 16 of which were aphakic. In addition to widespread silicone oil endothelial contact in 2 eyes, a bubble or droplets of silicone oil were observed in the anterior chamber in 8 eyes. The mean endothelial cell density was lower in the silicone eyes (2076 ± 196 cells/mm 2 ) as compared to the control fellow eyes (2738 ± 86 cells/mm 2 ) ( P =0.004). In eyes with silicone oil in the anterior chamber the endothelial cell density was significantly decreased (1857 ± 232 cells/mm 2 ) ( P =0.005). Obvious endothelial degeneration was noticed when silicone oil had been in the eye for more than a year. Also small droplets of oil with transient contact contributed to its development.
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A model of the electroretinogram useful for determining volume conductor effects was used to determine quantitatively the postvitrectomy effect of silicone oil on the ERG. The electrical conductivities of the structures of the eye, the frequency content of the ERG, and the percentage of silicone oil along with the remaining vitreous were incorporated in the model. The result was that it was not until at least 50% of the vitreous was replaced with silicone oil that there was a small reduction of the electroretinogram; this reduction increased nonlinearly as the percentage of silicone oil in the vitreal cavity increased. According to the model, if the vitreous replacement were large, little, if any, of the ERG would be measured even if the retina were quite functional.
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* BACKGROUND AND OBJECTIVES: Epimacular proliferation (EMP) represents a localized form of reproliferation at the macula. The significance of EMP in eyes that have undergone vitrectomy is still not clear. This study investigated the redetachment rate following silicone oil removal when combined with removal of EMP. * PATIENTS AND METHODS: Twenty-two consecutive eyes underwent removal of silicone oil and EME These eyes had attached retinas following silicone oil injection used as an adjunct to complex vitreoretinal surgery. * RESULTS: The retina remained attached in 19 (86.4%) of the eyes, with functional improvement in vision in 81.8% of the eyes. Visual acuity of 6/60 (20/200) or better was obtained in 12 (54.5%) of the eyes. The mean follow-up time was 6.3 months. * CONCLUSION: These results suggest that removal of EMP and silicone oil does not increase the risk of redetachment. [Ophthalmic Surg Lasers 1996;27:192-196.]
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A model of the ERG focusing on the insulation effect of silicone oil replacing the vitreous was used to quantify the ERG. The electrical properties of the structures of the eye, the frequency content of the ERG and the percentage of the silicone oil along with the remaining vitreous were incorporated in the model. The result was that it was not until at least 50 per cent of the vitreous was replaced with silicone oil that there was a small reduction in the ERG. As more silicone oil was put into the vitreous cavity the ERG became smaller. If the replacement were large leaving a layer of vitreous 0·24 mm thick, little ERG would be measured even if the retina were functional.
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Changes of Intraocular Pressure and Anterior Chamber Angle after Intravitreal Silicone Oil Injection
Objective To analyze the changes of intraocular pressure and anterior chamber angle after intravitreal silicone oil injection. Methods Retrospective analysis of intraocular pressure(IOP) was performed in 27 patients(29 eyes) after intravitreal silicone oil injection. Before the silicone oil was removed,all the eyes were examined by ultrasound biomicroscopy(UBM),slit-lamp microscope and non-contact tonometer. After the silicone oil was removed,all the eyes were examined by non-contact tonometer. Results Twelve eyes were diagnosed as silicone oil glaucoma(SOG). The incidence of SOG was 41.4%. Ocular hypertension began from the second day to 4 years after the operation during which silicone oil was injected. By ultrasound biomicroscopy and slit-lamp,It was found that there was more silicone oil in the anterior chamber,emulsified silicone oil,peripheral anterior synechia of iris,intraocular lens and aphacia in glaucoma eyes as compared with normal IOP eyes. After silicone oil removal,the IOP of most of silicone oil glaucoma eyes became normal. Conclusion Silicone oil in anterior chamber,emulsified silicone oil,peripheral anterior synechia of iris,intraocular lens and aphacia were the main causes of silicone oil glaucoma. Removing silicone oil was effective in treatment of silicone oil glaucoma.
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Ultrasound biomicroscopy
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To investigate the characteristics of retinal function in myopia using full-field electroretinogram (ERG) and multifocal ERG (MF-ERG) and to determine the correlation among MF-ERG, ocular axis length, retinal thickness and degree of myopia. Twenty emmetropes (20) and sixty-eight myopes (68) underwent manifest refraction, A- and B-scan, fundus examination, fluorescein angiography (FA), optical coherence tomography (OCT), full field ERG and MF-ERG. The amplitudes and implicit times of ERG were determined. The results were further analyzed by comparing ocular axis length, refraction, retinal thickness, and macular function detected by ERG parameters. There was a significant difference in implicit times of MF-ERG of an emmetrope and a moderate and high myopia whereas implicit times of mild myopia patients and emmetropes were similar. There was a statistically significant difference in amplitude densities of first positive peak of MF-ERG P1 wave between an emmetrope and a moderate and high myopia. In central ring and four quadrants, amplitude densities showed negative correlation to ocular axis length and diopter of myopia. There was no statistically significant difference between the average retinal thickness in emmetropic and physiological myopic eyes (low, medium, high), but there was significant difference between physiological and pathological myopia. Decreased foveal function as determined by MF-ERG is associated with high degree of myopia. Retinal function impairment is correlated with increase in the diopter of myopia, decrease of corrected visual acuity (VA), elongation of ocular axis and increased macular degeneration.
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Fundus (uterus)
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Purpose: To evaluate electroretinogram (ERG) changes after silicone oil removal. Methods: Scotopic and photopic ERGs, and best-corrected visual acuity (BCVA) were checked before and shortly after silicone oil removal in eyes that had previously undergone vitrectomy and silicone oil injection for complex retinal detachment. Preand postoperative ERG a- and b-wave amplitudes were compared. Results: Twenty-eight eyes of 28 patients including 20 male and 8 female subjects with mean age of 39.3 ± 0.06 (range, 12 to 85) years were studied. Mean interval from primary vitreoretinal surgery to silicone oil removal was 21.04 ± 0.52 (range, 7 to 39) months. Mean duration from silicone oil removal to second ERG was 13.04 ± 1.75 (range, 10 to 16) days. Before silicone oil removal, mean a-wave amplitudes in maximal combined response, rod response and cone response ERGs were 27.4 ± 19.9, 7.2 ± 4.5 and 5.5 ± 3.4 µv, respectively. These values increased to 48.8 ± 31.9, 15.1 ± 14.4 and 17.4 ± 22.2 µv, respectively after silicone oil removal (P < 0.001). Mean b-wave amplitudes in the same order, were 69.41 ± 51, 41.2 ± 30.4 and 25.1 ± 33.9 µv before silicone oil removal, increasing to 165.6 ± 102.5, 81.7 ± 53.7 and 44.7 ± 34.1 µv respectively, after silicone oil removal (P < 0.001). Mean BCVA significantly improved from 1.10 ± 0.34 at baseline to 1.02 ± 0.33 logMAR after silicone oil removal (P < 0.001). Conclusion: The amplitudes of ERG a- and b-waves under scotopic and photopic conditions increased significantly shortly after silicone oil removal. An increase in BCVA was also observed. These changes may be explained by the insulating effect of silicone oil on the retina.
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