Human Amniotic Membrane Graft Plug for Sclerotomy Closure of 23-Gauge Pars Plana Vitrectomy in Eyes with Silicone Oil Tamponade
Hussain Ahmad Khaqan
Department of Ophthalmology, Post Graduate Medical Institute, Ameer-ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan.
Laraib Hassan *
Department of Ophthalmology, Post Graduate Medical Institute, Ameer-ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan.
Hafiz Ateeq ur Rehman
Department of Ophthalmology, Post Graduate Medical Institute, Ameer-ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan.
Aamna Jabran
Department of Ophthalmology, Post Graduate Medical Institute, Ameer-ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan.
Nabeel Akram
Department of Ophthalmology, Post Graduate Medical Institute, Ameer-ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan.
Ahmad Fauzan
Post Graduate Medical Institute, Ameer-ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
The aim of this single-center, comparative, interventional case study is to elaborate a method to plug the 23-gauge pars plana vitrectomy sclerotomy using a human amniotic membrane in the eyes having internal tamponade of silicone oil. This study was conducted on 75 eyes of 75 patients who underwent 23-gauge pars plana vitrectomy with tamponade of silicone oil. Patients were divided into three groups based on sclerotomy closure. Group A consisted of 25 eyes in which the sclerotomy was closed with a human amniotic membrane, Group B consisted of 25 eyes in which the sclerotomy was closed with sutures, and Group C consisted of 25 eyes in which neither sutures nor human amniotic membrane were used. Patients were monitored for a total of six months. Hypotony and subconjunctival silicone oil were not seen in Group A. 12% of those in Group B had subconjunctival silicone oil leaks, but none had hypotonia. On the first postoperative day in Group C, 28% displayed subconjunctival silicone oil, and 16% displayed hypotonia. Further manipulation was required for these four hypotonus eyes; two required the use of sutures, and the other two required the use of a human amniotic membrane. We came to the conclusion that silicone oil tamponade with a human amniotic membrane plug appears to be a promising method for closing the vitrectomy sclerotomy in the eyes.
Keywords: Human amniotic membrane, pars plana vitrectomy, sclerotomy, silicone oil tamponade