Silicone oil-associated retinal light exposure under a surgical microscope
Silicone oil-associated retinal light exposure under a surgical microscope
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DOI：
10.1111/aos.14038
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发表时间：
2019-08-01
影响因子：
3.4
通讯作者：
Terasaki, Hiroko
中科院分区：
文献类型：
--
作者：
Yamada, Kazuhisa;Kaneko, Hiroki;Terasaki, Hiroko
目的基于折射率比水高的硅油（silicone oil，SO）在手术过程中会引起意外渐晕效应的假设，我们旨在使用手术显微镜研究SO体积与光强之间的关系。方法用光敏纸和填充不同体积（0%、50%、62.5%、75%、87.5%和100%）SO的模型眼，在手术显微镜下测量不同屈光度（0、10和20屈光度）的人工透镜（IOL）的光强。结果1.0%同轴斜光照射的曝光密度是0.1%同轴斜光照射的约22倍。此外，植入+20 D IOL的眼睛比未植入IOL的眼睛高约34倍。75%SO组眼密度最高，其次为0%SO组。75%和0%SO眼的光暴露密度显著高于其他体积SO眼。在充满SO的眼睛中，只有一个倾斜的光和一个过滤器的显微镜组成功地减少了曝光。结论硅油相关性视力下降（SORVL）可能是由于硅油相关性渐晕效应导致黄斑视网膜光照增加所致。SORVL可以通过在SO去除手术期间在显微镜中放置过滤器来预防。
Purpose Based on the hypothesis that silicone oil (SO) with a higher refractive index than water induces unexpected vignetting effects during surgeries, we aimed to investigate the relationship between the volume of SO and light intensity using a surgical microscope. Methods Using a light-sensitive paper and model eye filled with varying volumes (0%, 50%, 62.5%, 75%, 87.5% and 100%) of SO, the light intensity of intraocular lens (IOL) with various refractive powers (0, 10 and 20 dioptres) illuminated by a surgical microscope was measured. Results Light exposure density with 1.0% coaxial and oblique light was approximately 22-fold higher than that with 0.1% coaxial and oblique light. Further, it was approximately 34-fold higher in eyes with +20 D IOL than in those with no IOL. The density in eyes with 75% SO was the highest among all groups followed by that with 0% SO. Light exposure densities in the eyes with 75% and 0% SO were significantly higher than those with other volumes of SO. In SO-filled eyes, a microscope set with only an oblique light and a filter successfully reduced light exposure. Conclusion Silicone oil-related vision loss (SORVL) during SO removal surgeries might be due to increased light exposure on the macular retina caused by the SO-associated vignetting effect. SORVL could be prevented by placing a filter in the microscope during SO removal surgeries.