Ⅱ型增殖性糖尿病视网膜病变患者行玻璃体切除地机与术后视力 …

探讨Ⅱ型增殖性糖尿病视网膜病变合并严重玻璃本出血或合并血管纤维增殖引起的视网膜牵拉性视网膜脱离情况下,进行玻璃全切除术的手术时机。     

Different outcome among eyes with proliferative diabetic retinopathy indicated for vitrectomy

PURPOSE: The postoperative outcome was evaluated in each group of surgical indications of vitreous surgery for proliferative diabetic retinopathy (PDR), to investigate the factors responsible for postoperative visual prognosis. METHODS: Primary vitrectomy was performed in 119 eyes of 92 patients with PDR. Average postoperative follow-up period was 19 months. The indications for vitrectomy included vitrous hemorrhage in 58 eyes, macular tractional retinal detachment in 17 eyes, extramacular tractional retinal detachment in 10 eyes, macular heterotopia in 11 eyes, and progressive fibrovascular proliferation in the posterior fundus in 23 eyes. RESULTS: The visual acuity finally improved by 2 lines or more in 91 eyes (77%), remained unchanged in 10 eyes (8 %), and decreased by 2 lines or more in 18 eyes (15%). Final postoperative visual acuity was significantly better in cases of vitreous hemorrhage or progressive fibrovascular proliferation in the posterior fundus than in others. Preoperative rubeosis iridis and macular tractional retinal detachment were probably responsible for the final visual impairment, and intraocular tamponade affected the difference in visual prognosis between the groups of surgical indication. Multivariate analysis in all cases revealed that factors influencing visual outcome were preoperative rubeosis iridis and anemia. CONCLUSION: Rubeosis iridis and macular tractional retinal detachment were prognostic factors of the surgery. Vitrectomy for PDR may be effective in improving postoperative visual acuity if performed in the early stage of progressive fibrovascular proliferation in the posterior fundus after sufficient retinal photocoagulation.     

Retinal detachment following extracapsular cataract extraction and posterior chamber intraocular lens implantation.

Fourteen cases of primary retinal detachment after extracapsular cataract extraction and posterior chamber intraocular lens implantation were treated by scleral buckling surgery. Retinal reattachment was achieved in 100% of the cases. All eyes had a postoperative visual acuity of 6/30 or better; in six eyes the visual acuity was 6/12 or better. We attributed our high anatomical success rate to early detection of the retinal detachment, good visibility of the retinal breaks, lack of inflammatory reaction in the vitreous body, and preoperative absence of fixed retinal folds and preretinal membranes.     

Vitrectomy for nondiabetic vitreous hemorrhage. Not associated with vascular disease

Forty-nine consecutive eyes with nonclearing vitreous hemorrhage not associated with retinal or choroidal vascular disease underwent vitrectomy. Etiologies included vitreous hemorrhage during anterior segment surgery (22 eyes), blunt trauma (8 eyes), retinal tears with and without retinal detachment (8 eyes), Terson's syndrome (2 eyes), avulsed retinal vessel (1 eye), and idiopathic cases (8 eyes). The final visual acuity improved in 48 eyes (98%). Follow-up was 6-91 months (mean, 20 months). Of the 49 eyes, 40 eyes (82%) had a best postoperative visual acuity of 20/100 or better, 31 eyes (63%) had visual acuity of 20/40 or better, and 12 eyes (24%) had visual acuity of 20/20. The major complications included intraoperative iatrogenic retinal breaks (5 eyes), postoperative progressive cataract (7 eyes), late retinal detachment (4 eyes) and recurrent vitreous hemorrhage (2 eyes). The major complication associated with later visual loss was progressive cataract.     

Combined surgery, phacoemulsification, implantation of intraocular lens and pars plana vitrectomy

PURPOSE: To evaluate the effectiveness, technical feasibility and incidence of complications after combining pars plana vitrectomy, phacoemulsification and intraocular lens implantation. MATERIAL AND METHODS: The results of combined vitreoretinal and cataract surgery in 100 eyes of 96 patients were retrospectively and prospectively analyzed. The mean follow-up period was 8.4 months. All patients had clinically significant lens opacities and vitreoretinal pathology requiring pars plana vitrectomy. Indications for vitreoretinal surgery included: persistent vitreous haemorrhage (28 eyes), vitreous hemorrhage combined with tractional retinal detachment (50 eyes), tractional retinal detachment without vitreous haemorrhage caused by proliferative diabetic retinopathy (7 eyes), rheumatogenous retinal detachment with proliferative vitreoretinopathy (10 eyes) and dislocated crystalline lens in the vitreous (5 eyes). RESULTS: Postoperatively, best corrected visual acuity improved in 81 eyes (81%)- by two lines or more in 31 eyes (31%) - by less than two lines in 50 eyes (50%). In 14 eyes (14%) visual acuity was unchanged and was worse in 5 cases (5%). Postoperative complications included fibrin reaction, posterior synechias of the iris, vitreous hemorrhage, neovascular glaucoma, posterior capsule opacification, redetachment of retina. CONCLUSIONS: Our cases confirm previous study, that performing phacoemulsification, IOL implantation and vitrectomy in one operation is safe and allows visual recovery with good technical results.     

Cataract extraction in patients with chronic posterior uveitis

The surgical management of cataract in patients with chronic posterior uveitis is described. Of 41 eyes, 88% acquired improvement of the visual acuity 4 months postoperatively, which then remained stable in most of the cases during a follow-up of one year. The type of cataract extraction, extracapsular or intracapsular, did not influence these results, nor did the implantation of an intraocular lens. Recurrence of the uveitis occurred in about one third of the cases. Postoperative complications consisted of macular edema, retinal detachment and vitreous hemorrhage.     

Retinal detachment after cataract extraction and refractive lens exchange in highly myopic patients

PURPOSE: To assess the refractive effects and incidence of postoperative complications in patients with high myopia after cataract extraction. SETTING: University Eye Clinic, Trieste, Italy. METHODS: This noncomparative retrospective study comprised all eyes (N = 388) having cataract extraction and implantation of an intraocular lens with a power less than 11.0 diopters (D) between 1986 and 1999. The preoperative and postoperative refractions; preoperative, postoperative, and final best corrected visual acuity (BCVA); and postoperative complications were analyzed. The mean follow-up was 47.16 months +/- 32.83 (SD) (range 8 to 146 months). RESULTS: Phacoemulsification was performed in 237 eyes, extracapsular cataract extraction in 147 eyes, and intracapsular cataract extraction in 4 eyes. The mean preoperative BCVA was 0.20 +/- 0.21 and the mean postoperative BCVA, 0.58 +/- 0.32. At the final evaluation, the mean BCVA was 0.50 +/- 0.33. The mean refraction was -15.95 +/- 5.86 D preoperatively and -2.00 +/- 1.62 D postoperatively. One eye (0.26%) developed a retinal detachment postoperatively. Of the 127 eyes (32.73%) having a neodymium:YAG laser capsulotomy for posterior capsule opacification, 1 had a macular retinal hole. Posterior detachment of the vitreous occurred in 78.6% of cases. Peripheral retinal photocoagulation was required in 8 cases postoperatively. CONCLUSION: Refractive lens exchange led to good functional results and a low incidence of postoperative complications and can thus be regarded as a viable technique to correct high myopia associated with cataract. However, further study is required before it can be routinely recommended for the correction of high myopia in eyes with a transparent crystalline lens.     

Bilateral acute postoperative retinal detachment after cataract extraction: case report and review of the literature

A 57-year-old white man had extracapsular cataract extraction complicated by vitreous loss. On postoperative day 1, he was noted to have a total retinal detachment (RD) with vitreous hemorrhage. No predisposing anatomic risk factors were present except for the vitreous loss. During the RD repair, 2 small superior tears were discovered. Eleven months later, the patient had uneventful phacoemulsification in the fellow eye. On postoperative day 1, he again had a total RD with a superior retinal tear. Meticulous retinal evaluation had been performed preoperatively, and no holes or tears were discovered. The RD was repaired, and the best corrected visual acuity at the last examination was 20/40 in both eyes.     

Anterior retinal cryotherapy in diabetic vitreous hemorrhage

Recurrent vitreous hemorrhage associated with proliferative retinopathy can occur in eyes that do not satisfactorily respond to argon laser pantretinal photocoagulation. To evaluate the effect of relatively low-risk surgical intervention, we performed peripheral retinal cryopexy on 24 eyes of 23 diabetic patients with proliferative diabetic retinopathy and vitreous hemorrhage. In most cases, cryopexy followed complete or nearly complete panretinal photocoagulation which did not prevent subsequent vitreous hemorrhage. Existing vitreous hemorrhage cleared postoperatively in 23 of 24 eyes. The best corrected visual acuity improved in 15 eyes, remained unchanged in five, and worsened in four. Four postoperative anterior segment complications resolved completely within a short time. One patient, a 68-year-old woman who had had diabetes for 18 years, postoperatively had a macular hole in one eye and macular edema with tractional retinal detachment in the other.     

玻璃体积血合并视网膜裂孔或脱离的玻璃体切割手术疗效观察

目的:探讨玻璃体积血合并视网膜裂孔或脱离采用玻璃体切割手术治疗的疗效及必要性。 方法:对28例28眼玻璃体积血合并视网膜裂孔或脱离患者采用玻璃体切割手术治疗,观察治疗前后视力改变,并分析玻璃体积血与视网膜裂孔或脱离的关系。 结果:不同原因所导致的玻璃体积血28例中,7例术前B超未发现视网膜脱离,而在术中发现3例裂孔,4例伴裂孔周围浅脱;28例患者术后视力（包括术后随访最佳视力）均有不同程度的提高,数指/眼前以上者27例(96%),≥0.05者20例(71%),≥0.3者5例(18%),手术前后视力比较,具有统计学差异(P＜0.05)。 结论:玻璃体积血合并视网膜裂孔或脱离采用玻璃体切割手术治疗,安全有效,且能尽早发现视网膜裂孔及浅脱离,阻止视网膜脱离进一步扩大。     

Extracapsular cataract extraction: prognosis and complications with and without posterior-chamber lens implantations

Four-hundred-and-sixteen eyes that underwent cataract extraction over six years were analyzed. Extracapsular cataract extraction with posterior-chamber intraocular lens implantation (PCIOL) was performed in 186 eyes and extracapsular cataract extraction (ECCE) alone was performed in 230 eyes. The complications and visual acuity were compared in the two groups. The PCIOL group showed a low incidence of postoperative complications. In addition, there were no cases of corneal edema; retinal detachment occurred in 1.33%; cystoid macular edema occurred in 2.67%; and visual acuity recovered to 20/40 or better in 96.67% of eyes. The incidence of complications in the ECCE group was slightly higher.     

玻璃体切除联合不同眼内填充物治疗增性糖尿病视网膜病变的效果分析

目的 评估增殖型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)行玻璃体切割术的治疗效果.对PDR不同分期以及联合不同填充物的视力和并发症情况进行观察和比较,探讨其预后的差别.方法 对因PDR行玻璃体手术的病例300例(384只眼)进行随访,根据玻璃体切割术后不同填充物分为硅油填充组、全氟丙烷填充组和平衡盐水组三组,比较各组间的视力预后及并发症发生情况.结果 (1)术后视力:在观察的384只眼中,随访时视力较术前提高者有271只眼(70.6%);其中保留BSS灌注液患者中有78只眼(84.8%),填充气体患者有58眼(70.7%),填充硅油患者135只眼(64.3%)视力提高.经x2检验,各组间视力提高比例的差别无统计学意义(均P>0.05).(2)术后并发症:玻璃体再出血发生率以填充BSS组最高(23.9%),与硅油填充组(10.5%)比较差异有统计学(P<0.05);并发性白内障以硅油填充组(26.4%)最高,与填充BSS组相比差异具有统计学意义(P<0.05);视网膜脱离发生率以硅油填充组最高,与填充BSS组相比差异具有统计学意义(P<0.05);不同填充物各组间虹膜红变发生率未显示统计学差异.结论 (1)玻璃体切割联合不同填充物能有效地控制病情,及时有效的玻璃体手术是挽救严重PDR患者有用视功能的关键.(2)玻璃体出血、视网膜脱离、并发性白内障和青光眼是PDR患者玻璃体切割术后主要的并发症.硅油填充组的玻璃体出血发生率少于其他组,但并发性白内障发生率较其他组高;(3)尽管玻璃体切割术联合硅油填充会引起一些并发症,但硅油有屏障、限制出血扩散和视网膜复位的作用,为进一步完成全视网膜激光光凝创造了条件,巩固了手术治疗的效果,明显提高视网膜复位率及手术治疗成功率     

Results of cataract surgery in previously vitrectomized eyes

PURPOSE: To evaluate the difficulties and results of manual extracapsular cataract extraction (ECCE) and phacoemulsification cataract surgery performed in previously vitrectomized eyes. SETTING: Pécs University of Sciences, Faculty of Medicine, Department of Ophthalmology, Pécs, Hungary. METHODS: This retrospective case-control study comprised a series of 84 cataract extractions with or without intraocular lens implantation. Forty-three patients had manual ECCE and 41, phacoemulsification. The intraoperative and postoperative complications and visual outcomes in the 2 groups were analyzed and compared. RESULTS: Cataract extractions were performed a mean of 15.8 months (range 1 to 86 months) after the pars plana vitrectomy. The indications for vitrectomy were diabetic retinopathy, retinal detachment, proliferative vitreoretinopathy, giant retinal tear, macular hole, eye trauma, vitreous hemorrhage after central retinal vein occlusion, and uveitis. Primary posterior capsule fibrosis was the most common intraoperative complication, occurring in 24% of eyes. Posterior capsule rupture occurred in 5 eyes in the ECCE group and 3 in the phacoemulsification group. Zonulysis occurred in 2 and 1 eyes, respectively. A dropped nucleus occurred in 3 cases in the phacoemulsification group. Posterior capsule opacification and secondary glaucoma were the most common postoperative complications, occurring in 5 and 3 cases in the ECCE group, respectively, and in 3 and 4 cases in the phacoemulsification group. Visual acuity 6 weeks postoperatively improved or remained within 2 Snellen lines in 95% of eyes, which is comparable to data in the recent literature. CONCLUSIONS: Phacoemulsification gave better results than manual ECCE in previously vitrectomized eyes. Underlying retinal disease limited the final visual acuity.     

Short-term outcomes in eyes with posterior capsule rupture during cataract surgery

PURPOSE: To determine the short-term outcomes in eyes with posterior capsule rupture (PCR) during cataract surgery. SETTING: The Eye Institute, National Healthcare Group, Tan Tock Seng Hospital, Singapore, Singapore. METHODS: All intraoperative complications during cataract surgery were reported prospectively as part of a clinical audit program. The clinical charts of all patients who had PCR during cataract surgery from July 1995 to December 1998 were retrospectively reviewed. RESULTS: Posterior capsule rupture occurred in 155 (1.9%) of 8230 consecutive eyes that had extracapsular cataract extraction (ECCE) or phacoemulsification. Thirteen cases were excluded from analysis for missing data or insufficient follow-up. Of the remaining 142 eyes, 100 (70.4%) achieved a best corrected visual acuity (BCVA) of 6/12 or better between 6 weeks and 3 months postoperatively. Excluding 27 eyes with preexisting ocular pathology contributing to impaired vision, 87.0% achieved a BCVA of 6/12 or better. Fifteen eyes (13.0%) failed to achieve that acuity because of cystoid macular edema (CME) (2 eyes), posterior capsule opacification (2 eyes), endophthalmitis (1 eye), glaucoma (1 eye), retinal detachment (1 eye), CME, central retinal artery occlusion, and vitreous hemorrhage (1 eye) or unknown reasons (7 eyes). Risk factors for a poor visual outcome included older age, presence of coexisting ocular pathology, ECCE, implantation of an anterior chamber intraocular lens, and vitreous loss requiring anterior vitrectomy. CONCLUSIONS: Most eyes with PCR achieved a good BCVA in the early postoperative period.     

玻璃体切除联合白内障手术治疗55例PDR疗效分析

目的:评价玻璃体切除联合晶状体超声乳化及人工晶状体植入术治疗增生性糖尿病视网膜病变(PDR)的疗效及并发症。方法:回顾性分析55例68眼伴有白内障的PDR患者行玻璃体切除联合晶状体超声乳化及人工晶状体植入术的临床资料,观察术后视力改善程度及术中、术后并发症。结果:术后随访3～24(平均8.5)mo。51眼(75%)术后视力维持或改善,17眼(25%)视力下降,其中无光感6眼(9%);术中并发症为医源性视网膜裂孔15眼(22%);术后并发症:前房炎性反应30眼(44%),玻璃体积血11眼(16%),复发性视网膜脱离3眼(4%),虹膜红变5眼(7%),新生血管性青光眼2眼(3%);31眼(46%)术后需要继续眼内光凝。结论:玻璃体切除联合晶状体超声乳化及人工晶状体植入术治疗PDR,可使大多数患者的视力改善,手术是安全的,手术成功的关键为选择合适的患者,影响术后视力的主要因素为视网膜病变程度。     

Outcomes of vitreoretinal surgery for complications of branch retinal vein occlusion

OBJECTIVE: To investigate outcomes of vitreoretinal surgery for complications of branch retinal vein occlusion (BRVO). DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: The medical records of all patients who underwent vitreoretinal surgery for complications of BRVO at Bascom Palmer Eye Institute between January 1, 1991 and December 31, 1998 were reviewed. Thirty-six eyes from 36 consecutive patients were identified. MAIN OUTCOME MEASURES: Visual acuity outcomes include preservation of preoperative visual acuity and visual acuity greater than or equal to 20/40, 20/200 and 5/200. When preoperative retinal detachment was present, the anatomic outcome assessed was complete retinal attachment. Postoperative event rates of retinal detachment, vitreous hemorrhage, epiretinal membrane (ERM), and cataract were tabulated. All outcomes were assessed at 6 months. RESULTS: Surgical indications included nonclearing vitreous hemorrhage (17 patients), traction retinal detachment involving the macula (15), and ERM (4). Mean follow-up was 19 months. Preoperatively, best-corrected vision was greater than or equal to 20/200 in 19/36 (53%) eyes. Six months postoperatively, best-corrected vision was greater than or equal to 20/40 in 12/36 (33%) eyes, greater than or equal to 20/200 in 27/36 (75%) eyes, and greater than or equal to 5/200 in 31/36 (86%) eyes. Postoperative complications included retinal detachment (2/36; 6% eyes), ERM (3; 8%), vitreous hemorrhage (2; 6%), suprachoroidal hemorrhage (1; 3%), central retinal vein occlusion (1; 3%), and central retinal artery occlusion (1; 3%). Clinical features associated with better visual outcome include better preoperative visual acuity (P: = 0.05), absence of preoperative afferent pupillary defect (P: = 0.01), and absence of preoperative macular edema (P: = 0.08). CONCLUSIONS: Following surgery, retinal attachment and improved visual acuity were achieved in the majority of patients. Pre-existing pathology and postoperative complications may limit final vision in eyes with BRVO.     

Posterior chamber lens implantation concurrent with vitrectomy for proliferative diabetic retinopathy

Combined operation of cataract removal with posterior chamber intraocular lens implantation and pars plana vitrectomy were performed on 25 eyes in 22 patients with cataract concurrent with diabetic retinopathy. In 21 eyes, extracapsular cataract extraction followed by intraocular lens insertion, aiming at in-the-bag fixation, was performed, and in 4 eyes pars plana lensectomy with anterior capsule left and intraocular lens insertion between the iris and anterior capsule was carried out. Mean postoperative follow-up period was 14 months, ranging from 3 to 32 months. Visual acuity on the last examination was 0.5 or better in 2 eyes (8%), 0.1 or better in 12 eyes (48%), and worse than 0.05 in 9 eyes (36%). Major postoperative complications were fibrin reaction (20 eyes, 80%), pupillary deformation (19 eyes, 76%), pupil capture by intraocular lens (3 eyes, 12%), rhegmatogenous retinal detachment (1 eye, 4%), neovascular glaucoma (2 eyes, 8%), and recurrent vitreous hemorrhage (13 eyes, 52%). Intraocular pressure was well controlled in neovascular glaucoma cases. At the last examination ocular fundus was invisible due to vitreous hemorrhage in two eyes.     

严重PDR玻璃体切割术后雷珠单抗注射的效果观察

目的：对严重增殖性糖尿病视网膜病变的患者行玻璃体切割术后行雷珠单抗注射的效果观察。方法：回归性分析。12例严重增殖性糖尿病视网膜病变患者(12眼)接受睫状体平坦部玻璃体切割术,同时给予硅油、惰性气体或者平衡液的玻璃体腔填充。在手术结束的同时给予雷珠单抗的玻璃体腔注射。结果：随访时间平均为2.75 mo。这12眼中分别包括玻璃体积血(1眼);玻璃体积血伴纤维血管化增生(1眼);玻璃体积血伴牵拉性视网膜脱离(3眼);纤维血管化增生伴牵拉性视网膜脱离(2眼);玻璃体积血伴新生血管性青光眼伴牵拉性视网膜脱离(1眼);玻璃体积血伴纤维血管化增生伴牵拉性视网膜脱离(2眼);玻璃体积血伴纤维血管化增生伴新生血管性青光眼伴牵拉性视网膜脱离(1眼);玻璃体积血伴牵拉性孔源性视网膜脱离(1眼)。12眼中,8眼行玻璃体腔硅油填充,2眼行惰性气体填充,2眼行平衡液填充。所有的患者之前均未接受任何治疗。视网膜脱离复位率为10/10(100%)。1眼术后出现前房积血。9眼术后最佳矫正视力较术前提高,2眼无明显变化,1眼较术前下降。 OCT检查显示8眼术后未见黄斑水肿。结论：玻璃体切割术后雷珠单抗注射对严重增殖性糖尿病视网膜病变患者有明显的治疗效果：手术成功率明显提高;患者视力显著提高;糖尿病黄斑水肿的发生概率减少;术中及术后并发症的发生率降低。     

Vitrectomy in Terson syndrome. Report of 18 cases]

A vitrectomy was performed in 18 eyes (15 patients) with vitreous hemorrhages due to Terson's syndrome. The average age of the patients was 46.5 +/- 14.4 years. The mean interval between the acute event of an intracranial hemorrhage and the vitrectomy was 6.8 +/- 4.9 months. The vitreous hemorrhage was associated with epiretinal membranes in 3, PVR in 2, and retinal breaks and/or rhegmatogenous retinal detachment in 3 eyes. The vitrectomy had to be combined with membrane peeling in 2, encircling procedures or exoplants in 4, cryotherapy in 5, endolaser in 1, and air/SF6 gas filling in 3 eyes. A missing or incomplete posterior vitreous detachment in 8 eyes was associated with a higher risk of PVR and retinal detachment. Two eyes with this condition needed 3 secondary operations. The mean follow-up duration was 32 (1 to 126) months. Two patients died 4 and 11 months after the operation. The visual acuity improved significantly following vitrectomy in all 18 eyes. The final visual acuity was better than 20/40 in 73% and 20/25 to 20/20 in 56%. The initial postoperative visual acuity decreased later on due to nuclear cataract in 7 of 10 eyes of patients over 45 years of age. A complicated cataract developed in only 1 of 8 eyes of younger patients who maintained a mean visual acuity of 20/25. Vitrectomy for Terson's syndrome is recommended in bilateral cases without spontaneous clearing of the vitreous within 3 months, as well as in cases with PVR and imminent retinal detachment.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cataract Surgery and Transpupillary Silicone Oil Removal Through a Single Scleral Tunnel Incision Under Topical Anesthesia; Sutureless Surgery

The author evaluated the results of combined cataract extraction and transpupillary silicone oil removal through a single scleral tunnel incision, in eyes that had undergone pars plana vitrectomy with silicone oil tamponade. Twenty-four of the 46 eyes were operated on under topical anesthesia with Blumenthal mode mini-nucleus manual extracapsular cataract extraction technique (mini-nuc ECCE), and silicone oil was removed passively through planned posterior capsulorhexis via the scleral tunnel, followed by endocapsular intraocular lens (IOL) implantation. The operation was completed without any suturing. The remaining 22 eyes were similarly operated on with the same cataract extraction technique, but in these cases silicone oil was classically aspirated actively through pars plana sclerotomies. Results were evaluated by visual acuity measurement, duration of operation, and complications. The transpupillary silicone oil removal group had significantly less vitreous hemorrhage (0- 31.8%) and posterior capsule opacification (0-36.4%). Also, the mean duration of the operation was significantly shorter in this group. There was no significant difference between the two groups with regard to postoperative recurrence of retinal detachment (12.5-18.1%) and visual acuity outcome. The combination of mini-nuc ECCE with transpupillary silicone oil removal compares favorably with the combination of silicone oil aspiration through pars plana sclerotomies. This combined technique allows the surgeon to perform the operation under topical anesthesia and no sutures are required. The intervention period is shorter and no posterior capsule opacification or vitreous hemorrhage develops.