Name of the Procedure:

Retinal Tamponade Device, Silicone Oil (C1814)

Common Name: Retinal Silicone Oil Injection
Technical Terms: Retinal tamponade procedure, intraocular silicone oil tamponade

Summary

This procedure involves the injection of silicone oil into the eye to help keep the retina in place after retinal detachment surgery. The oil acts as a temporary tamponade, or support device, to stabilize the retina until it can heal properly.

Purpose

The primary goal of this procedure is to treat retinal detachment, a condition where the retina peels away from its underlying layer of support tissue. By stabilizing the retina, the silicone oil helps to reattach it, reducing the risk of vision loss and promoting proper healing.

Indications

• Retinal detachment
• Persistent retinal breaks or tears
• Complex retinal conditions requiring surgical intervention
• Vitreous hemorrhage (bleeding into the gel-like substance inside the eye)

Preparation

• Fasting: Patients might need to fast for several hours before the procedure.
• Medication Adjustments: Patients may need to stop taking blood thinners or other medications that could increase surgical risks.
• Pre-Procedure Tests: Eye examinations, including ultrasound and Optical Coherence Tomography (OCT), may be needed to assess the retina's condition.

Procedure Description

1. The patient is given local or general anesthesia.
2. A small incision is made in the sclera (white part of the eye).
3. Any present vitreous humor causing traction is removed through a vitrectomy.
4. The surgeon injects silicone oil into the eye to press the retina against the wall of the eye.
5. The incisions are then closed, and a temporary eye shield may be applied.

Tools and Equipment:

• Vitrectomy system
• Silicone oil injection device
• Microscopic surgical instruments
• Anesthesia equipment

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity of the case.

Setting

Usually performed in a hospital's ophthalmic surgery center or an outpatient surgical facility.

Personnel

• Ophthalmic Surgeon (particularly a retinal specialist)
• Anesthesiologist or Nurse Anesthetist
• Surgical Nurses and Technicians

Risks and Complications

• Infection
• Increased intraocular pressure (glaucoma)
• Cataract formation
• Oil emulsification (breakdown of silicone oil)
• Retinal re-detachment
• Visual disturbances due to the presence of silicone oil

Benefits

• Reattachment of the retina, which can preserve or improve vision.
• Stabilization of the eye structure, reducing the risk of further retinal damage.
• Enhanced healing of the retina.

Recovery

• Patients are usually advised to maintain specific head positions to ensure the oil stays in place.
• Follow-up appointments are necessary to monitor healing.
• Eye drops or medications may be prescribed to manage intraocular pressure and prevent infection.
• Silicone oil may need to be removed in a subsequent procedure, typically within a few months to a year.

Alternatives

• Gas bubble tamponade
• Scleral buckling (where a band is placed around the eye to push the retina into place)
• Observation and less invasive treatments for minor tears (e.g., laser photocoagulation or cryopexy)

Pros and Cons:

• Silicone oil tamponade is often used for more complex retinal detachments and offers a more stable support compared to gas bubbles. However, it often requires a secondary procedure for oil removal.

Patient Experience

During the procedure, patients will be under anesthesia and should not feel pain. Post-procedure, patients might experience discomfort, blurry vision, and the sensation of a foreign substance in the eye. Pain management and proper care instructions will be provided to ensure comfort and promote healing. Regular follow-up visits are crucial to monitor progress and manage any potential complications.