Use of 30 gauge needle to prevent hypotony during silicone oil removal

Abstract

Silicone oil (SO) is used as an intraocular tamponade after complex vitreoretinal surgeries because of its properties such as transparency, inertness, high surface tension, and interfacial tension with water. The only disadvantage of SO tamponade is the need for a second surgery for its removal. However, there is a risk of ocular hypotony soon after the removal of the infusion cannula, especially in retinal vascular conditions, such as diabetic retinopathy. We hereby present a silicone oil removal (SOR) technique using a 30 G needle that prevents intraocular hypotony during SOR.

Figure 1

(a) Per-operative image of the right eye showing post silicone oil removal, air-fluid exchange, and suture of superior ports. The infusion cannula is still connected. (b) A 30 G needle attached to the automated air pump is inserted into the vitreous cavity at 3.5–4 mm away from the limbus

Figure 2

(a) The infusion cannula is removed and sutured using 7–0 vicryl keeping the 30 G needle in the vitreous cavity to maintain the intraocular pressure. (b) The 30 G needle is removed at the end followed by a gentle massage