IRCCS Fondazione Bietti-ONLUS, Rome, Italy.
Department of Physics, University of Genoa, Genoa, Italy.
Transl Vis Sci Technol. 2023 Apr 3;12(4):21. doi: 10.1167/tvst.12.4.21.
To compare the efficacy of two surgical techniques used to remove silicone oil (SiO) emulsion tamponade after pars plana vitrectomy: triple air-fluid exchange (AFX) and balanced salt solution lavage (BSSL).
X-ray photoemission spectroscopy measured silicon content of the dry residue of fluid samples taken during AFX and BSSL. Ten patients underwent AFX and five BSSL. Three fluid samples were taken per patient, and the dry residue of 10 drops per sample were analyzed. A fluid sample from a patient who never received SiO tamponade was also analyzed to set a "blank" reference sample.
Patients' demographics showed no significant difference. Sample 1 of the two groups contained comparable silicon content while samples 2 and 3 of the AFX group contained significantly more silicon than that of the BSSL group (15.0 ± 0.1 and 12.0 ± 0.9 for the AFX group vs. 10.7 ± 1.4 and 5.2 ± 0.6 for the BSSL group, respectively; P < 0.05). The cumulative amount of silicon in the three successive samples was also significantly higher for the AFX group (42.3 ± 1.6 vs. 32 ± 2; P < 0.0001). The average silicon content ratio of consecutive samples was significantly higher for the AFX group compared to the BSSL group (0.90 ± 0.01 vs. 0.58 ± 0.06; P = 0.006).
Triple AFX removed more silicon than triple lavage. The eye wall actively interacts with silicon emulsion retaining silicon content rather than behaving as a neutral container.
Triple air-fluid exchange removed more silicon than BSS lavage. Neither technique behaved as a well-mixed box dilution, suggesting the eye walls actively retain emulsion and a dynamic equilibrium is established between silicon dispersion and the eye wall surface.
比较两种用于去除经睫状体平坦部玻璃体切割术后硅油（SiO）乳剂填塞的手术技术的疗效：三次空气-液体交换（AFX）和平衡盐溶液灌洗（BSSL）。
X 射线光电子能谱测量在 AFX 和 BSSL 过程中采集的流体样本的干燥残留物中的硅含量。10 例患者接受了 AFX，5 例患者接受了 BSSL。每位患者采集 3 个样本，分析每个样本 10 滴的干燥残留物。还分析了一位从未接受过 SiO 填塞的患者的流体样本作为“空白”参考样本。
患者的人口统计学特征无显著差异。两组的样本 1 均含有相当的硅含量，而 AFX 组的样本 2 和样本 3 则含有明显更多的硅，分别比 BSSL 组多 15.0±0.1 和 12.0±0.9（分别为 15.0±0.1 和 12.0±0.9；P<0.05）。AFX 组三个连续样本中的累积硅量也明显更高（42.3±1.6 与 32±2；P<0.0001）。与 BSSL 组相比，AFX 组连续样本的平均硅含量比值明显更高（0.90±0.01 与 0.58±0.06；P=0.006）。
三次 AFX 清除的硅比三次冲洗清除的更多。眼球壁与硅乳剂积极相互作用，保留硅含量，而不是表现为中性容器。
三次空气-液体交换比 BSS 冲洗清除的硅更多。两种技术都没有表现为均匀混合的盒稀释，这表明眼球壁积极保留乳剂，并且硅分散体和眼球壁表面之间建立了动态平衡。
