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Trocar Opening: A Novel Management Strategy for Silicone Oil Removal with Phacoemulsification and Iol Implantation

Xu Zhang, Yajie Pan and Zhengyu Song

Objective: To evaluate the efficacy and safety of a novel management strategy (Trocar opening) in silicone oil removal (SOR) in combination with phacoemulsification and IOL implantation.
Methods: There were 60 eyes of 60 patients with cataract and silicone oil-filled eyes enrolled in this study. All of the patients were divided into two groups: the patients in control group received 23G pars plana active SOR surgery with phacoemulsification and IOL implantation, while the patients in TO group received trocar opening methods during surgery. Best corrected visual acuity (BCVA), surgery time; intraocular pressure (IOP) and operative complications were observed in six months after surgery.
Results: There was no significant difference between the 2 groups for age, gender, preoperative, IOP or time of silicone oil stay. All patients were successfully completed their surgery. At 6 month after surgery, the mean BCVA improved from 1.34 ± 0.44 (control group) and 1.36 ± 0.42 (TO group) before surgery to 0.74 ± 0.36 (control group) and 0.77 ± 0.32 (TO group) after surgery (P<0.001), respectively, and there was no significant difference between the 2 groups. The mean SOR time was 6.9 ± 2.3 min in control group, while 4.8 ± 1.2 min in TO group (P=0.008). The mean cataract time was 8.4 ± 3.2 in control group, while 7.2 ± 2.6 min in TO group (P=0.013). The total operation time was 28.2 ± 8.5 min in control group, and 24.6 ± 6.4 min in TO group (P=0.035). Four eyes experienced posterior capsule rupture in control group, while none in TO group (P0.01). There was 1 eye occurred late recurrent retinal detachment 2 months after surgery in control group and 1 eye 4 mo in TO group. No other postoperative complication was observed such as vitreous hemorrhage, dislocated IOL, or endophthalmitis.
Conclusion: Our finding indicates that trocar opening is a simple, effective, time saving and safe method for SOR combined with phacoemulsification and IOL implantation.