Department of Ophthalmology, Al-Shifa Trust Eye Hospital, Islamabad, Pakistan.
Department of Ophthalmology, Shifa College of Medicine, Islamabad, Pakistan.
J Pak Med Assoc. 2023 Jun;73(6):1314-1316. doi: 10.47391/JPMA.6823.
Suprachoroidal silicone oil migration is an unusual complication of small gauge 3 ports Pars plana vitrectomy (3PPV) system. Our objective is to report a retrospective, observational case of an intra-operative suprachoroidal silicone oil (SO) migration during 27 gauge 3PPV and its successful surgical management. A 49 years old male patient with type 2 diabetes, presented to the ophthalmology outpatient department with reduced visual acuity in his right eye. He was diagnosed as having tractional retinal detachment involving macula. During combined phaco-vitrectomy following injection of SO, peripheral choroidal elevations were noted suggesting suprachoroidal SO migration. In an attempt to drain this intra-operatively nasal sclerotomy was enlarged. Post-operative B scan showed significant choroidal detachment for which patient was re-scheduled for surgery after 1 day. Three radial trans-scleral incisions (2 nasal and 1 temporal) for drainage were made at the site of maximum choroidal detachment. By massaging and widening these scleral incisions, suprachoroidal haemorrhage and SO was successfully drained with good post-operative visual improvement.
脉络膜下硅油迁移是小规格 3 端口经睫状体平坦部玻璃体切除术（3PPV）系统的一种罕见并发症。我们的目的是报告一例术中脉络膜下硅油（SO）迁移的回顾性观察病例，该病例发生在 27G 3PPV 期间，并成功进行了手术治疗。一名 49 岁男性糖尿病患者，因右眼视力下降到眼科门诊就诊。他被诊断为患有牵拉性视网膜脱离合并黄斑。在注油后行联合超声乳化玻璃体切除术时，发现周边脉络膜隆起，提示脉络膜下 SO 迁移。为了在术中引流，鼻侧巩膜切开术被扩大。术后 B 超显示明显的脉络膜脱离，因此患者在 1 天后再次接受手术。在脉络膜脱离最严重的部位做了 3 个放射状经巩膜切口（2 个鼻侧和 1 个颞侧）进行引流。通过按摩和扩大这些巩膜切口，成功地排出了脉络膜下出血和 SO，术后视力得到了很好的改善。
