Timing of intravitreal foldable capsular vitreous body implantation after silicone oil tamponade
摘要
To evaluate the timing of intravitreal of foldable capsular vitreous body (FCVB) implantation following silicone oil tamponade in patients with severe ocular trauma.
MethodsThis retrospective study included two groups of patients with severe ocular trauma who were selected from a single unit. Those in Group A underwent direct FCVB implantation without prior silicone oil tamponade, whereas those in Group B underwent temporary silicone oil tamponade before delayed FCVB implantation. Surgical outcomes and complications, including anterior chamber hemorrhage, anterior chamber shallowness, elevated intraocular pressure (IOP), and ocular pain, were observed and compared between the two groups over a one-year follow-up period to determine the optimal implantation timing.
ResultsA total of 52 patients (52 eyes) were enrolled between January 2019 and January 2024, with 12 patients in Group A and 40 in Group B. The retinal reattachment rate in each group was 75% and 91%, respectively. Among the 15 patients who experienced anterior segment-related complications, 11 were in Group A, and 4 were in Group B. The results revealed that Group A demonstrated a higher mean follow-up IOP (27.8 mmHg) than did Group B (10.9 mmHg), and some patients required intervention for ocular hypertension. Kaplan‒Meier analysis indicated that silicone oil tamponade for ≤ 0.3 months increased the risk of anterior complications compared with that for > 0.3 months (P = 0.0176). Ultimately, fewer complications were observed in Group B than in Group A. Very short tamponade durations may not allow adequate ocular stabilization prior to FCVB implantation, contributing to increased risks of inflammation and elevated IOP. Based on clinical observations and survival analysis, the optimal timing for FCVB implantation appears to be between 2 and 3 months after initial silicone oil tamponade.
ConclusionFollowing severe ocular trauma, a two-stage surgical approach—initial silicone oil tamponade followed by FCVB implantation after 2–3 months—yields the best treatment outcomes with minimal complications. These findings provide important guidance for clinicians in selecting the appropriate timing for FCVB surgery.