RESUMEN
PURPOSE: To clarify the postoperative incidence of macular edema in patients undergoing surgery to repair rhegmatogenous retinal detachment and identify the associated risk factors. METHODS: In this prospective, observational study, 79 patients who underwent surgery to correct rhegmatogenous retinal detachment using pars plana vitrectomy with silicone oil injection were analyzed. Patients were followed up postoperatively at 7, 30, 90, 180, and 365 days. At each visit, optical coherence tomography was performed to assess the presence or absence of macular edema. were analyzed as possible risk factors for macular edema: age, sex, macular status (attached or detached), presence of vitreoretinal proliferation, history of previous intraocular surgery, reported time of symptoms suggestive of rhegmatogenous retinal detachment up to the date of surgery, and the surgical modality performed. RESULTS: The 1-year macular edema prevalence rate was 26.6%. In the adjusted analysis, older patients had a higher risk of macular edema, and each 1-year increase in age increased the risk of macular edema by 6% (95% confidence interval = 1.00-1.12). The macular status, vitreoretinal proliferation, the surgical technique used, prior intraocular surgery, and the intraocular lens status were not identified as risk factors. However, the incidence of macular edema increased up to 180 days after surgery, peaking at 10.6%, and then decreased until 365 days after surgery. CONCLUSION: Macular edema was a common complication after surgery to treat rhegmatogenous retinal detachment, with its incidence peaking between 30 and 180 days after surgery. Age was an important risk factor for macular edema in this cohort.
Asunto(s)
Edema Macular , Desprendimiento de Retina , Tomografía de Coherencia Óptica , Vitrectomía , Humanos , Desprendimiento de Retina/cirugía , Desprendimiento de Retina/etiología , Masculino , Femenino , Edema Macular/etiología , Edema Macular/epidemiología , Persona de Mediana Edad , Factores de Riesgo , Estudios Prospectivos , Vitrectomía/efectos adversos , Vitrectomía/métodos , Incidencia , Adulto , Estudios de Seguimiento , Tomografía de Coherencia Óptica/métodos , Anciano , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Agudeza Visual , Aceites de Silicona/efectos adversos , Aceites de Silicona/administración & dosificación , Factores de Tiempo , Factores de Edad , Adulto JovenRESUMEN
RESUMO O óleo de silicone é um importante tampão utilizado na retinopexia cirúrgica de casos graves de descolamento de retina. O aumento da pressão intraocular e o desenvolvimento de glaucoma secundário são frequentes complicações da sua utilização. A depender do período de aparecimento, diversos mecanismos justificam a ocorrência de tais complicações. Compreender os fatores de riscos e a patogênese do aumento da pressão intraocular associada a aplicação de óleo de silicone em cirurgia retiniana ajuda a orientar o tratamento adequado para cada paciente. O objetivo deste artigo é revisar a literatura sobre a patogenia, a incidência, os fatores de risco e o tratamento desta condição clínica.
ABSTRACT Silicone oil has been an important intraocular tamponade in retinopexy in cases of complicated retinal detachment surgery. The increase of intraocular pressure and development of secondary glaucoma are a known complication of its use. A variety of mechanisms have been proposed for the pathogenesis, depending on the onset. This article aims to review the literature about pathogenesis, the incidence and risk factors, as well as the treatment of this pathology.
Asunto(s)
Humanos , Aceites de Silicona/efectos adversos , Aceites de Silicona/uso terapéutico , Desprendimiento de Retina/terapia , Glaucoma/inducido químicamente , Hipertensión Ocular/inducido químicamente , Presión Intraocular/efectos de los fármacos , Complicaciones Posoperatorias , Malla Trabecular , Desprendimiento de Retina/cirugía , Trabeculectomía , Glaucoma/cirugía , Factores de Riesgo , Implantes de Drenaje de Glaucoma , Terapia por Láser , Oclusión Terapéutica/métodos , FotocoagulaciónRESUMEN
AIM: Main failure of diabetic tractional retinal detachment (TRD) surgery is the development of proliferative vitreoretinopathy (PVR), causing higher re-detachment rates. We investigated whether the use of dexamethasone (DEX) implant at the end of pars plana vitrectomy (PPV) with silicone oil tamponade might have an impact on these outcomes. DESIGN: Comparative, nonrandomized, retrospective study. PARTICIPANTS: A total of 148 eyes from 148 patients that underwent PPV with silicone oil tamponade for diabetic TRD (with DEX implant, n = 52; without DEX implant, n = 96). METHODS: Consecutive patients' records were reviewed for time between TRD diagnosis and surgery; lens status before surgery and after 6, 12, and 24 months; retina attachment rate after primary PPV; change in postoperative PVR severity; rate of re-detachment at 6, 12, and 24 months; use of IOP lowering treatment after 6, 12, and 24 months; surgery details; intra- and postoperative complications. Correlations between outcome measures, postoperative PVR severity, and re-detachment rates were analyzed. MAIN OUTCOME MEASURES: Change in postoperative PVR severity and retinal re-detachment rates with and without the adjuvant use of DEX implant. RESULTS: Retinal re-detachment rates were significantly higher in the group of patients that did not receive DEX implant [11/96 (11.5%) vs. 0/52 (0%), p = 0.049; 11/84 (12.9%) vs. 4/52 (7.7%), p = 0.007; 14/71 (19.7%) vs. 5/52 (10%) p < 0.001 at 6, 12, and 24 months, respectively]. PVR severity correlated with retinal status at 12 and 24 months (p = 0.018 and p = 0.027, respectively). The difference in PVR severity between the two groups was statistically significant at 6, 12, and 24 months (p < 0.001). CONCLUSIONS: DEX implant at the end of PPV in patients with diabetic TRD improves PVR severity and decreases re-detachment rates. This should be considered as an option in the customized treatment of TRD.
Asunto(s)
Dexametasona/administración & dosificación , Retinopatía Diabética/tratamiento farmacológico , Retinopatía Diabética/cirugía , Desprendimiento de Retina/tratamiento farmacológico , Desprendimiento de Retina/cirugía , Vitrectomía/métodos , Adulto , Anciano , Terapia Combinada , Dexametasona/efectos adversos , Retinopatía Diabética/complicaciones , Implantes de Medicamentos/administración & dosificación , Implantes de Medicamentos/efectos adversos , Femenino , Humanos , Inyecciones Intravítreas , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Periodo Posoperatorio , Retina/efectos de los fármacos , Retina/fisiopatología , Estudios Retrospectivos , Aceites de Silicona/administración & dosificación , Aceites de Silicona/efectos adversos , Agudeza Visual/efectos de los fármacos , Vitrectomía/efectos adversos , Vitreorretinopatía Proliferativa/tratamiento farmacológico , Vitreorretinopatía Proliferativa/etiología , Vitreorretinopatía Proliferativa/cirugíaRESUMEN
RESUMEN Objetivo: Evaluar la efectividad de la cirugía de catarata para el control de la presión intraocular en pacientes vitrectomizados con aceite de silicona remitidos de la consulta de Retina al Servicio de Catarata del Instituto Cubano de Oftalmología Ramón Pando Ferrer, en el período comprendido de enero de 2016 a enero de 2017. Métodos: Se realizó un estudio descriptivo prospectivo de series de casos en 20 pacientes. El universo quedó conformado por todos los pacientes vitrectomizados, a quienes se les colocó aceite de silicona como sustituto del vítreo con diagnóstico de catarata e hipertensión ocular. Resultados: Los pacientes vitrectomizados con aceite de silicona, a quienes se les realizó cirugía de catarata, se caracterizaron por un predominio del sexo masculino y la edad menor de 60 años, asociado a enfermedad vitreorretiniana de base. La cirugía de catarata se relacionó con una importante disminución de la presión intraocular en el posoperatorio. Todos los pacientes alcanzaron un ángulo camerular abierto posterior a la cirugía, que favoreció la disminución del uso de tratamiento tópico. No fue necesaria la cirugía filtrante posterior a esta. Conclusiones: En los pacientes vitrectomizados, la cirugía de catarata muestra una mejoría sostenida de las presiones intraoculares hasta el sexto mes del posoperatorio(AU)
ABSTRACT Objective: Evaluate the effectiveness of cataract surgery to control intraocular pressure in patients undergoing vitrectomy with silicone injection referred by retina specialists to the Cataract Service of Ramón Pando Ferrer Cuban Institute of Ophthalmology from January 2016 to January 2017. Methods: A descriptive prospective case-series study was conducted of 20 patients. The universe was all the patients undergoing vitrectomy with administration of silicone oil as a vitreal substitute who were diagnosed with cataract and ocular hypertension. Results: Patients undergoing vitrectomy with silicone oil injection and cataract surgery were mostly male, mean age was under 60 years, and a relationship was found to underlying vitreoretinal disease. Cataract surgery was associated to a considerable reduction in intraocular pressure in the postoperative period. All patients achieved an open chamber angle after surgery, leading to a reduction in the use of topical medication. Eventual filtration surgery was not required. Conclusions: In patients undergoing vitrectomy, cataract surgery leads to sustained intraocular pressure improvement until the sixth month of the postoperative period(AU)
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Aceites de Silicona/efectos adversos , Hipertensión Ocular/epidemiología , Facoemulsificación/métodos , Cirugía Vitreorretiniana/métodos , Epidemiología Descriptiva , Estudios Prospectivos , Estudios LongitudinalesRESUMEN
BACKGROUND: Pupillary block induced by silicon oil in vitrectomized patients is a common condition usually treated with Nd-YAG laser iridotomy or with surgical removal of silicon oil. CASE REPORT: A case of silicone oil pupillary block glaucoma successfully treated with a 30 G needle transfixion technique is described. We performed a non-complicated vitrectomy surgery for retinal detachment with proliferative vitreoretinopathy that included lensectomy, inferior peripheral iridectomy, and silicone oil injection. After surgery, the iridectomy became occluded with fibrous tissue and the intraocular pressure raised to 50 mmHg. After an initial Nd-YAG iridotomy was unsuccessful, we passed a 30 Ga needle through the sclerocorneal limbus and cut the fibrous tissue that blocked the iridectomy. This procedure restored the aqueous humor flow through the iridectomy, pushed back the silicone oil bubble into the vitreous cavity and lowered the intraocular pressure to normal levels. CONCLUSIONS: 30 Ga needle transfixion technique could be an effective, low cost, simple alternative for the treatment of silicone oil pupillary block in aphakic patients.
ANTECEDENTES: El bloqueo pupilar secundario a aceite de silicón en pacientes vitrectomizados es una condición frecuente que normalmente se trata con apertura de la iridectomía con láser Nd-YAG o con el retiro del aceite de silicón. CASO CLÍNICO: Se describe un caso de glaucoma secundario a bloqueo pupilar por aceite de silicón tratado satisfactoriamente con técnica de transfixión con aguja de calibre 30. Realizamos una cirugía de vitrectomía sin complicaciones para el tratamiento de un desprendimiento de retina con vitreorretinopatía proliferativa, que incluyó lensectomía, iridectomía periférica inferior e inyección de aceite de silicón. Después de la cirugía, la iridectomía se ocluyó con tejido fibroso y la presión intraocular se incrementó a 50 mmHg. Después de que una iridotomía inicial con láser Nd-YAG no tuvo éxito, pasamos una aguja de calibre 30 a través del limbo esclerocorneal y cortamos el tejido fibroso que bloqueaba la iridectomía. Este procedimiento restauró el flujo de humor acuoso a través de la iridectomía, desplazando la burbuja de aceite de silicón a la cavidad vítrea, y la presión intraocular descendió a valores normales. CONCLUSIONES: La técnica de transfixión con aguja de calibre 30 puede ser una alternativa efectiva, simple y de bajo costo para el tratamiento del bloqueo pupilar con aceite de silicón en pacientes con afaquia.
Asunto(s)
Cirugía Filtrante/métodos , Glaucoma/terapia , Desprendimiento de Retina/terapia , Aceites de Silicona/efectos adversos , Atención Ambulatoria , Afaquia Poscatarata/complicaciones , Femenino , Cirugía Filtrante/instrumentación , Glaucoma/etiología , Humanos , Iridectomía/métodos , Láseres de Estado Sólido/uso terapéutico , Persona de Mediana EdadRESUMEN
Silicone oil injections are often used for soft tissue augmentation and local and general adverse effects occurring from a few months to 15 years after injection have been reported. Here, we present a case of delayed granuloma formation due to liquid injectable silicone with large extent of involvement, which precluded surgical removal. Our patient was successfully treated with minocycline, considering its anti-inflammatory, immunomodulating and antigranulomatous properties. This case presents minocycline monotherapy as a useful treatment option for the management of severe granuloma induced by silicone use when surgical excision is not possible.
Asunto(s)
Antibacterianos/uso terapéutico , Granuloma de Cuerpo Extraño/tratamiento farmacológico , Minociclina/uso terapéutico , Enfermedades de la Piel/tratamiento farmacológico , Adulto , Femenino , Granuloma de Cuerpo Extraño/inducido químicamente , Humanos , Aceites de Silicona/efectos adversos , Enfermedades de la Piel/inducido químicamenteRESUMEN
OBJECTIVE: To analyze a case series of patients who underwent injection of industrial liquid silicone in a clandestine manner and by unauthorized persons. METHODS: We conducted a retrospective analysis of medical records of patients treated between September 2003 and December 2010. Data regarding gender, age, location and volume of silicone injected, time between application and clinical manifestations, complications, treatment and outcome were collected. Early manifestations were defined as occurring within 30 days of injection and late manifestations, the ones arising after this period. RESULTS: We treated 12 patients, eight were male, seven transsexuals. The volume injected ranged from 5 ml to 2000 ml, being unknown in three cases. The most often used injected sites were the thighs and buttocks. Eight patients had early manifestations, with inflammation and/or infection. Surgical debridement was necessary in five cases. Three patients with a history of injection in the breast region underwent adenomastectomy. There was one death due to refractory septic shock. CONCLUSION: The use of industrial liquid silicone should be completely contraindicated as a filling material and modification of body contouring, and may have serious complications, even death.
Asunto(s)
Técnicas Cosméticas/efectos adversos , Aceites de Silicona/administración & dosificación , Aceites de Silicona/efectos adversos , Adulto , Femenino , Humanos , Inyecciones , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJETIVO: analisar uma série de casos de pacientes submetidos à injeção de silicone líquido industrial de maneira clandestina e por pessoas não habilitadas. MÉTODOS: análise retrospectiva de prontuários de pacientes atendidos no período de setembro de 2003 a dezembro de 2010. Foram avaliados: sexo, idade, local e volume de silicone injetado, tempo decorrido entre a aplicação e as manifestações clínicas, complicações, tratamento e evolução. Definiu-se como precoce as manifestações ocorridas até 30 dias da injeção e manifestações tardias após este período. RESULTADOS: Foram atendidos 12 pacientes, oito eram do sexo masculino, sendo sete transexuais. O volume injetado variou de 5ml a 2000ml, sendo desconhecido em três casos. Os locais mais frequentemente utilizados para injeção foram a região de coxas e glúteos. Oito casos apresentaram manifestações precoces, com quadros de inflamação e/ou infecção. Foi necessária a realização de desbridamento cirúrgico em cinco casos. Três pacientes com histórico de injeção na região mamária foram submetidas à adenomastectomia. Houve um óbito por quadro de choque séptico refratário. CONCLUSÃO: O uso do silicone líquido industrial deve ser totalmente contraindicado como material de preenchimento e modificação do contorno corporal, podendo apresentar graves complicações e até mesmo óbito.
OBJECTIVE: To analyze a case series of patients who underwent injection of industrial liquid silicone in a clandestine manner and by unauthorized persons. METHODS: We conducted a retrospective analysis of medical records of patients treated between September 2003 and December 2010. Data regarding gender, age, location and volume of silicone injected, time between application and clinical manifestations, complications, treatment and outcome were collected. Early manifestations were defined as occurring within 30 days of injection and late manifestations, the ones arising after this period. RESULTS: We treated 12 patients, eight were male, seven transsexuals. The volume injected ranged from 5ml to 2000ml, being unknown in three cases. The most often used injected sites were the thighs and buttocks. Eight patients had early manifestations, with inflammation and/or infection. Surgical debridement was necessary in five cases. Three patients with a history of injection in the breast region underwent adenomastectomy. There was one death due to refractory septic shock. CONCLUSION: The use of industrial liquid silicone should be completely contraindicated as a filling material and modification of body contouring, and may have serious complications, even death.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Técnicas Cosméticas/efectos adversos , Aceites de Silicona/administración & dosificación , Aceites de Silicona/efectos adversos , Inyecciones , Estudios RetrospectivosRESUMEN
INTRODUÇÃO: O silicone líquido industrial tem sido introduzido no organismo humano de forma clandestina, com a finalidade de corrigir defeitos, depressões, irregularidades e para aumentar volumes, tanto em mulheres como em homens ou transgêneros. Com tal uso, podem ocorrer várias complicações, tais como infecções, necroses teciduais e, mais tardiamente, a migração do produto, pelo sistema linfático, venoso ou mesmo pela força da gravidade. MÉTODO: Foram avaliados 11 pacientes portadores de siliconomas, pertencentes ao ambulatório do Serviço de Cirurgia Plástica do Hospital Universitário da UFJF e da Clínica Plastic Center, em Juiz de Fora, MG, no período de janeiro de 2005 a dezembro de 2010. Desses, 7 eram do gênero masculino e quatro do gênero feminino, sendo que desse total, 3 eram transgêneros. Todos os pacientes referiam com clareza o material injetado em seus organismos e todos fizeram o procedimento em ambiente não hospitalar e por indivíduos leigos. CONCLUSÃO: Este artigo tem como objetivo maior esclarecer as consequências danosas que esse produto pode causar no organismo, como cicatrizes de grandes proporções e sequelas estéticas e funcionais.
INTRODUCTION: The industrial liquid silicone has been introduced in the human body in a clandestine manner, with the purpose of correcting defects, depressions, irregularities and to increase volumes in women, men or transgenders. Several complications can occur, such as infection, tissue necrosis, and later migration of the product through the lymphatic system, venous system, or even by force of gravity. METHODS: Eleven patients with siliconomas, belonging to the ambulatory service of plastic surgery of Hospital Universitário da UFJF and Clinic Plastic Center in Juiz de Fora, MG, were evaluated from January 2005 to December 2010. Of these, 7 were male and 4 female, and there were 3 transvestites. All patients clearly referred the material injected into their bodies and have done all the procedure in a non-hospital environment and by lay individuals. CONCLUSION: This article's primary goal is to clarify the harmful consequences that this product may cause to the body such as scars and major aesthetic and functional sequelae.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Cicatriz , Aceites de Silicona/efectos adversos , Aceites de Silicona/toxicidad , Complicaciones Posoperatorias , Siliconas , Procedimientos Quirúrgicos Operativos , Técnicas y Procedimientos Diagnósticos , Métodos , PacientesRESUMEN
PURPOSE: To evaluate the outcomes of pars plana vitrectomy and silicone oil injection for the treatment of infectious endophthalmitis. METHODS: 35 cases of endophthalmitis secondary to phacoemulsification (20 patients), trabeculectomy (8 patients), perforating trauma (2 patients), trauma (2 patients), corneal transplantation (1 patient), vitrectomy (1 patient) and corneal ulceration (1 patient) were retrospectively studied. Patients were separated into two groups: Group 1 (n=24): intravitreal antibiotic injection, associated with topical and oral antibiotics; Group 2 (n=11): vitrectomy with intravitreal antibiotic injection and silicone oil injection. The follow-up ranged from 1 to 48 months (mean of 16 months). RESULTS: From 24 patients in group 1, 11 patients (45.83%), had infection controlled with intravitreal antibiotic injection only; 13 patients (54.15%) regressed to uncontrolled endophthalmitis, in which two patients (8.33%) were submitted to evisceration and one patient (4.16%) had corneal melting. The remaining 10 patients (41.66%) with uncontrolled endophthalmitis were submitted to pars plana vitrectomy and silicone oil injection. Six patients (25%) from Group I had retinal detachment during the first month of follow-up and also required pars plana vitrectomy and silicone oil injection. In Group 2 patients (n=11), all of them had controlled infection at the first procedure. In one case (9.09%), a severe proliferative vitreoretinopathy induced loss of vision. CONCLUSION: These results suggest that silicone oil tamponade might be beneficial in the treatment strategy of infectious endophthalmitis.
Asunto(s)
Antibacterianos/administración & dosificación , Endoftalmitis/cirugía , Aceites de Silicona/administración & dosificación , Vitrectomía/métodos , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Quimioterapia Combinada , Endoftalmitis/etiología , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Aceites de Silicona/efectos adversos , Resultado del Tratamiento , Vitrectomía/efectos adversos , Adulto JovenRESUMEN
PURPOSE: To evaluate the outcomes of pars plana vitrectomy and silicone oil injection for the treatment of infectious endophthalmitis. METHODS: 35 cases of endophthalmitis secondary to phacoemulsification (20 patients), trabeculectomy (8 patients), perforating trauma (2 patients), trauma (2 patients), corneal transplantation (1 patient), vitrectomy (1 patient) and corneal ulceration (1 patient) were retrospectively studied. Patients were separated into two groups: Group 1 (n=24): intravitreal antibiotic injection, associated with topical and oral antibiotics; Group 2 (n=11): vitrectomy with intravitreal antibiotic injection and silicone oil injection. The follow-up ranged from 1 to 48 months (mean of 16 months). RESULTS: From 24 patients in group 1, 11 patients (45.83 percent), had infection controlled with intravitreal antibiotic injection only; 13 patients (54.15 percent) regressed to uncontrolled endophthalmitis, in which two patients (8.33 percent) were submitted to evisceration and one patient (4.16 percent) had corneal melting. The remaining 10 patients (41.66 percent) with uncontrolled endophthalmitis were submitted to pars plana vitrectomy and silicone oil injection. Six patients (25 percent) from Group I had retinal detachment during the first month of follow-up and also required pars plana vitrectomy and silicone oil injection. In Group 2 patients (n=11), all of them had controlled infection at the first procedure. In one case (9.09 percent), a severe proliferatative vitreoretinopathy induced loss of vision. CONCLUSION: These results suggest that silicone oil tamponade might be beneficial in the treatment strategy of infectious endophthalmitis.
OBJETIVO: Avaliar os resultados da vitrectomia pars plana com tamponamento com óleo de silicone no tratamento de endoftalmite aguda. MÉTODOS: Trinta e cinco pacientes com endoftalmite, sendo 20 secundário à facoemulsificação, 8 por trabeculectomia, 2 por trauma perfurante, 2 por trauma, 1 por transplante de córnea, 1 por vitrectomia, e 1 por úlcera de córnea, foram estudados retrospectivamente. Os pacientes foram separados em dois grupos. Grupo 1 (n=24): injeção de antibiótico intravítreo (AIV), associado com antibióticos oral e sistêmico; Grupo 2 (n=11): vitrectomia com AIV e óleo de silicone. O seguimento variou de 1 a 48 meses (média de 16 meses). RESULTADOS: Dos 24 pacientes no Grupo 1, 11 (45,83 por cento) tiveram controle da infecção apenas com injeção AIV, 13 (54,15 por cento) não controlaram a endoftalmite, sendo que, dois destes (8,33 por cento) foram submetidos à evisceração e um (4,16 por cento) evoluiu para "melting" corneano. Os outros 10 (41,66 por cento) pacientes foram submetidos à vitrectomia pars plana e óleo de silicone. Seis pacientes (25 por cento) do Grupo 1 tiveram descolamento de retina e também necessitaram de vitrectomia pars plana e óleo de silicone. No Grupo 2 (n=11), todos tiveram controle da infecção no primeiro procedimento e não necessitaram de mais intervenções, exceto pela remoção do óleo de silicone três meses depois. CONCLUSÃO:Os resultados sugerem que o tamponamento por óleo de silicone parece ser benéfico na estratégia de tratamento da endoftalmite infecciosa aguda.
Asunto(s)
Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Humanos , Persona de Mediana Edad , Adulto Joven , Antibacterianos/administración & dosificación , Endoftalmitis/cirugía , Aceites de Silicona/administración & dosificación , Vitrectomía/métodos , Enfermedad Aguda , Quimioterapia Combinada , Endoftalmitis/etiología , Estudios Retrospectivos , Aceites de Silicona/efectos adversos , Resultado del Tratamiento , Vitrectomía/efectos adversos , Adulto JovenRESUMEN
Despite scientific literature replete with stories of disastrous results and disfigurement, illicit subcutaneous injections of massive quantities of highly viscous fluids are still performed, often by unqualified persons. The authors present a devastating long-term outcome of subcutaneous injections of a massive volume of silicone oil in the buttocks of a 46-year-old female patient and its resolution through dermolipectomy of the thighs and buttocks.
Asunto(s)
Nalgas , Lipectomía/métodos , Aceites de Silicona/efectos adversos , Muslo , Femenino , Humanos , Inyecciones , Persona de Mediana Edad , Aceites de Silicona/administración & dosificaciónRESUMEN
O silicone líquido foi introduzido no início do século XX comfinalidade estética e reparadora, teve seu apogeu no Japão, nadécada de 1950, e logo após apareceram as primeiraspublicações das reações adversas e suas complicações,principalmente com a prática de injeção ilícita dessa substânciapor pessoas não qualificadas. Este trabalho tem finalidade derealizar uma revisão bibliográfica sobre os efeitos da injeção desilicone líquido a propósito de casos de necrose de mamas.
The liquid silicon was introduced begin in the XXs century withaesthetic and reparative purpose, had its acme in Japan, in thedecade of 1950, and soon after they appeared the firstpublications of the adverse reactions and their complications,mainly with the practice of illicit injection of that nourishes forunqualified people. This work has purpose of accomplishing abibliographical revision on the effects of the injection of liquidsilicon concerning cases of necrosis of breast.
Asunto(s)
Humanos , Masculino , Adolescente , Enfermedades de la Mama , Inyecciones/efectos adversos , Aceites de Silicona/efectos adversos , Siliconas/efectos adversos , Técnicas y Procedimientos Diagnósticos , Métodos , Necrosis , Cirugía PlásticaRESUMEN
PURPOSE: To demonstrate optical coherence tomography efficacy to evaluate macular anatomical outcomes, in eyes with silicone oil-filled vitreous cavity after vitrectomy. METHODS: A descriptive observational study of 28 (twenty-eight) patients submitted to pars plana vitrectomy having silicone oil as vitreous substitute. The macular findings were observed by means of indirect binocular ophthalmoscope, biomicroscopy and optical coherence tomography examinations. RESULTS: During the follow-up period the retina remained attached in all patients. In some cases, intraretinal cysts, epiretinal membrane and lamellar macular hole were observed only by optical coherence tomography examination. CONCLUSION: Optical coherence tomography provided improved imaging of finer retinal structures in eyes with silicone oil-filled vitreous cavity. Therefore, optical coherence tomography examination should be systematically performed in eyes filled with silicone oil to recognize changes in retinal morphology.
Asunto(s)
Técnicas de Diagnóstico Oftalmológico/normas , Retina/patología , Aceites de Silicona/administración & dosificación , Vitrectomía , Adulto , Anciano , Membrana Epirretinal/etiología , Estudios de Evaluación como Asunto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Oftalmoscopios , Periodo Posoperatorio , Retina/cirugía , Perforaciones de la Retina/etiología , Aceites de Silicona/efectos adversos , Tomografía de Coherencia Óptica/normasRESUMEN
OBJETIVO: Demonstrar a eficácia da tomografia de coerência óptica na avaliação da estrutura anatômica macular em olhos com a cavidade vítrea preenchida por óleo de silicone. MÉTODOS: Estudo observacional descritivo de 28 (vinte e oito) pacientes submetidos a vitrectomia com utilização de óleo de silicone como substituto vítreo. Estes pacientes foram avaliados pela biomicroscopia, oftalmoscopia indireta e pela tomografia de coerência óptica. RESULTADO: Todos os pacientes apresentaram retina aplicada no pós-operatório. A realização da tomografia de coerência óptica não apresentou dificuldade técnica na sua execução. O "cisto" de retina, membrana epi-retiniana e buraco lamelar foram apenas detectados na tomografia de coerência óptica. CONCLUSÃO: A tomografia de coerência óptica demonstrou boa eficácia para detectar alterações maculares em olhos com óleo de silicone. Assim, evidenciamos que é factível a execução deste exame e que este pode nos ajudar a diagnosticar alterações subclínicas no pós-operatório nestes pacientes.
PURPOSE: To demonstrate optical coherence tomography efficacy to evaluate macular anatomical outcomes, in eyes with silicone oil-filled vitreous cavity after vitrectomy. METHODS: A descriptive observational study of 28 (twenty-eight) patients submitted to pars plana vitrectomy having silicone oil as vitreous substitute. The macular findings were observed by means of indirect binocular ophthalmoscope, biomicroscopy and optical coherence tomography examinations. RESULTS: During the follow-up period the retina remained attached in all patients. In some cases, intraretinal cysts, epiretinal membrane and lamellar macular hole were observed only by optical coherence tomography examination. CONCLUSION: Optical coherence tomography provided improved imaging of finer retinal structures in eyes with silicone oil-filled vitreous cavity. Therefore, optical coherence tomography examination should be systematically performed in eyes filled with silicone oil to recognize changes in retinal morphology.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Técnicas de Diagnóstico Oftalmológico/normas , Retina/patología , Aceites de Silicona/administración & dosificación , Estudio de Evaluación , Membrana Epirretinal/etiología , Estudios de Seguimiento , Microscopía , Oftalmoscopios , Periodo Posoperatorio , Retina/cirugía , Perforaciones de la Retina/etiología , Aceites de Silicona/efectos adversos , Tomografía de Coherencia Óptica/normas , VitrectomíaRESUMEN
The objective of this report is to demonstrate the effectiveness of an iris prosthesis to treat a refractory glaucoma induced by silicone oil in the anterior chamber. This case is about a patient who suffered a trauma caused by firearm shrapnel. A vitreous-retinal surgery was performed to remove intraocular foreign matter and to realign the retina that was detached. Due to the partial traumatic aniridia, silicone oil that was introduced in the vitreous chamber to keep the retina in place migrated to the anterior chamber, resulting in the decrease of endothelium cells and uncontrollable intraocular pressure. We performed transscleral fixation of the iris prosthesis to correct these problems. After a 45-month period of evolution, sight became stable at the 1 meter finger-count distance and intra-ocular pressure at 14 mmHg We may conclude that the triad that consists of lack of: iris diaphragm, aphakia and silicone oil that could not be removed because of inexorable occurrence of detachment of the retina should lead the surgeon to consider transscleral fixation of the iris prosthesis. This procedure might control intraocular pressure and/or preserve corneal transparency, preventing silicone oil from contact with the trabecular net and the corneal endothelium.