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Gustavo Barreto Melo - One of the best experts on this subject based on the ideXlab platform.
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Agitation of the syringe and release of Silicone Oil
Eye, 2020Co-Authors: Celso De Souza Dias Junior, Alexandre Lima Cardoso, Ana Galrão De Almeida Figueiredo, Gustavo Barreto MeloAbstract:Background/objectives To investigate whether agitation promotes the release of Silicone Oil by different models of syringe used for intravitreal injection. Methods This lab study analyzed eight syringe models by light microscopy for the release of Silicone Oil under agitation (flick), without agitation, and positive controls. Fourier-Transform Infrared Spectroscopy (FTIR) was performed to identify the molecular compounds inside the syringes. Results A total of 240 syringes were analyzed. The presence of Silicone Oil droplets was observed in all positive controls. When agitated by flicking, 100% of the samples of the syringes disclosed Silicone Oil, except the BD Plastipak syringe, which presented 40% of positivity. Without agitation, a smaller percentage of samples with Silicone Oil was observed. Agitation by flicking had a 265-fold greater chance of presenting Oil droplets when compared with the syringes without agitation. There was a statistically significant difference between the three conditions ( P
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Release of Silicone Oil droplets from syringes
International Journal of Retina and Vitreous, 2019Co-Authors: Gustavo Barreto Melo, Celso De Souza Dias Junior, Mariana Reis Carvalho, Alexandre Lima Cardoso, Fábio Barreto Morais, Acácio Alves Souza Lima Filho, Geoffrey Guy Emerson, Ana Carolina Migliorini Figueira, Mauricio MaiaAbstract:BackgroundIntravitreal Silicone Oil droplets have been found in the vitreous. The aim of this study is to compare the rates of Silicone Oil released by different brands of commonly used syringes for intravitreal injection after agitation by flicking.MethodsThree models of two brands of syringes were analyzed for their rates of Silicone Oil release: Saldanha Rodrigues (SR) 1 mL insulin syringe (SR, Brazil, syringe 1), Becton–Dickinson (BD) Plastipak 1 mL insulin syringe (Brazil, syringe 2), and BD Safety-Glide 1 mL insulin syringe (USA, syringe 3). All syringes were tested under four different conditions: positive control (fluid with addition of Silicone Oil) without agitation (group 1, n = 5); positive control with agitation (group 2, n = 3); fluid only without agitation (group 3, n = 5); and fluid only with agitation (group 4, n = 5). Masked graders performed all analyses using light microscopy.ResultsAll syringes (1, 2, and 3) released Silicone Oil droplets in the positive control group regardless of the agitation status (groups 1 and 2). When no Oil was added and the syringes were not agitated, only syringe 1 released Silicone Oil droplets (40% of samples). After agitation, syringes 1 and 3 released Silicone Oil droplets in all samples. Quantitative analysis showed a significantly ( P = 0.011; 11.2 ± 2.9 vs. 0.6 ± 0.9, respectively) higher mean number of Silicone Oil droplets released by syringe 1 after agitation compared to no agitation. Syringe 1 also had significantly ( P = 0.002, 11.2 ± 2.9 vs. 0.0 ± 0.0 vs. 2.2 ± 0.8, respectively) more droplets than syringes 2 and 3 after agitation.ConclusionsSyringes commonly used for intravitreal injections frequently release Silicone Oil droplets when agitated by flicking, especially the SR insulin ones. We recommend that they not be agitated at the time of intravitreal injection and that the manufacturers consider producing syringes adapted for intraocular use.
Celso De Souza Dias Junior - One of the best experts on this subject based on the ideXlab platform.
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Agitation of the syringe and release of Silicone Oil
Eye, 2020Co-Authors: Celso De Souza Dias Junior, Alexandre Lima Cardoso, Ana Galrão De Almeida Figueiredo, Gustavo Barreto MeloAbstract:Background/objectives To investigate whether agitation promotes the release of Silicone Oil by different models of syringe used for intravitreal injection. Methods This lab study analyzed eight syringe models by light microscopy for the release of Silicone Oil under agitation (flick), without agitation, and positive controls. Fourier-Transform Infrared Spectroscopy (FTIR) was performed to identify the molecular compounds inside the syringes. Results A total of 240 syringes were analyzed. The presence of Silicone Oil droplets was observed in all positive controls. When agitated by flicking, 100% of the samples of the syringes disclosed Silicone Oil, except the BD Plastipak syringe, which presented 40% of positivity. Without agitation, a smaller percentage of samples with Silicone Oil was observed. Agitation by flicking had a 265-fold greater chance of presenting Oil droplets when compared with the syringes without agitation. There was a statistically significant difference between the three conditions ( P
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Release of Silicone Oil droplets from syringes
International Journal of Retina and Vitreous, 2019Co-Authors: Gustavo Barreto Melo, Celso De Souza Dias Junior, Mariana Reis Carvalho, Alexandre Lima Cardoso, Fábio Barreto Morais, Acácio Alves Souza Lima Filho, Geoffrey Guy Emerson, Ana Carolina Migliorini Figueira, Mauricio MaiaAbstract:BackgroundIntravitreal Silicone Oil droplets have been found in the vitreous. The aim of this study is to compare the rates of Silicone Oil released by different brands of commonly used syringes for intravitreal injection after agitation by flicking.MethodsThree models of two brands of syringes were analyzed for their rates of Silicone Oil release: Saldanha Rodrigues (SR) 1 mL insulin syringe (SR, Brazil, syringe 1), Becton–Dickinson (BD) Plastipak 1 mL insulin syringe (Brazil, syringe 2), and BD Safety-Glide 1 mL insulin syringe (USA, syringe 3). All syringes were tested under four different conditions: positive control (fluid with addition of Silicone Oil) without agitation (group 1, n = 5); positive control with agitation (group 2, n = 3); fluid only without agitation (group 3, n = 5); and fluid only with agitation (group 4, n = 5). Masked graders performed all analyses using light microscopy.ResultsAll syringes (1, 2, and 3) released Silicone Oil droplets in the positive control group regardless of the agitation status (groups 1 and 2). When no Oil was added and the syringes were not agitated, only syringe 1 released Silicone Oil droplets (40% of samples). After agitation, syringes 1 and 3 released Silicone Oil droplets in all samples. Quantitative analysis showed a significantly ( P = 0.011; 11.2 ± 2.9 vs. 0.6 ± 0.9, respectively) higher mean number of Silicone Oil droplets released by syringe 1 after agitation compared to no agitation. Syringe 1 also had significantly ( P = 0.002, 11.2 ± 2.9 vs. 0.0 ± 0.0 vs. 2.2 ± 0.8, respectively) more droplets than syringes 2 and 3 after agitation.ConclusionsSyringes commonly used for intravitreal injections frequently release Silicone Oil droplets when agitated by flicking, especially the SR insulin ones. We recommend that they not be agitated at the time of intravitreal injection and that the manufacturers consider producing syringes adapted for intraocular use.
Alexandre Lima Cardoso - One of the best experts on this subject based on the ideXlab platform.
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Agitation of the syringe and release of Silicone Oil.
Eye, 2020Co-Authors: Celso De Souza Dias Junior, Alexandre Lima Cardoso, Ana Galrão De Almeida Figueiredo, Gustavo B. MeloAbstract:To investigate whether agitation promotes the release of Silicone Oil by different models of syringe used for intravitreal injection. This lab study analyzed eight syringe models by light microscopy for the release of Silicone Oil under agitation (flick), without agitation, and positive controls. Fourier-Transform Infrared Spectroscopy (FTIR) was performed to identify the molecular compounds inside the syringes. A total of 240 syringes were analyzed. The presence of Silicone Oil droplets was observed in all positive controls. When agitated by flicking, 100% of the samples of the syringes disclosed Silicone Oil, except the BD Plastipak syringe, which presented 40% of positivity. Without agitation, a smaller percentage of samples with Silicone Oil was observed. Agitation by flicking had a 265-fold greater chance of presenting Oil droplets when compared with the syringes without agitation. There was a statistically significant difference between the three conditions (P
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Agitation of the syringe and release of Silicone Oil
Eye, 2020Co-Authors: Celso De Souza Dias Junior, Alexandre Lima Cardoso, Ana Galrão De Almeida Figueiredo, Gustavo Barreto MeloAbstract:Background/objectives To investigate whether agitation promotes the release of Silicone Oil by different models of syringe used for intravitreal injection. Methods This lab study analyzed eight syringe models by light microscopy for the release of Silicone Oil under agitation (flick), without agitation, and positive controls. Fourier-Transform Infrared Spectroscopy (FTIR) was performed to identify the molecular compounds inside the syringes. Results A total of 240 syringes were analyzed. The presence of Silicone Oil droplets was observed in all positive controls. When agitated by flicking, 100% of the samples of the syringes disclosed Silicone Oil, except the BD Plastipak syringe, which presented 40% of positivity. Without agitation, a smaller percentage of samples with Silicone Oil was observed. Agitation by flicking had a 265-fold greater chance of presenting Oil droplets when compared with the syringes without agitation. There was a statistically significant difference between the three conditions ( P
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Release of Silicone Oil droplets from syringes
International Journal of Retina and Vitreous, 2019Co-Authors: Gustavo Barreto Melo, Celso De Souza Dias Junior, Mariana Reis Carvalho, Alexandre Lima Cardoso, Fábio Barreto Morais, Acácio Alves Souza Lima Filho, Geoffrey Guy Emerson, Ana Carolina Migliorini Figueira, Mauricio MaiaAbstract:BackgroundIntravitreal Silicone Oil droplets have been found in the vitreous. The aim of this study is to compare the rates of Silicone Oil released by different brands of commonly used syringes for intravitreal injection after agitation by flicking.MethodsThree models of two brands of syringes were analyzed for their rates of Silicone Oil release: Saldanha Rodrigues (SR) 1 mL insulin syringe (SR, Brazil, syringe 1), Becton–Dickinson (BD) Plastipak 1 mL insulin syringe (Brazil, syringe 2), and BD Safety-Glide 1 mL insulin syringe (USA, syringe 3). All syringes were tested under four different conditions: positive control (fluid with addition of Silicone Oil) without agitation (group 1, n = 5); positive control with agitation (group 2, n = 3); fluid only without agitation (group 3, n = 5); and fluid only with agitation (group 4, n = 5). Masked graders performed all analyses using light microscopy.ResultsAll syringes (1, 2, and 3) released Silicone Oil droplets in the positive control group regardless of the agitation status (groups 1 and 2). When no Oil was added and the syringes were not agitated, only syringe 1 released Silicone Oil droplets (40% of samples). After agitation, syringes 1 and 3 released Silicone Oil droplets in all samples. Quantitative analysis showed a significantly ( P = 0.011; 11.2 ± 2.9 vs. 0.6 ± 0.9, respectively) higher mean number of Silicone Oil droplets released by syringe 1 after agitation compared to no agitation. Syringe 1 also had significantly ( P = 0.002, 11.2 ± 2.9 vs. 0.0 ± 0.0 vs. 2.2 ± 0.8, respectively) more droplets than syringes 2 and 3 after agitation.ConclusionsSyringes commonly used for intravitreal injections frequently release Silicone Oil droplets when agitated by flicking, especially the SR insulin ones. We recommend that they not be agitated at the time of intravitreal injection and that the manufacturers consider producing syringes adapted for intraocular use.
Paul Sullivan - One of the best experts on this subject based on the ideXlab platform.
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using spectral domain optical coherence tomography imaging to identify the presence of retinal Silicone Oil emulsification after Silicone Oil tamponade
Retina-the Journal of Retinal and Vitreous Diseases, 2013Co-Authors: Mariehelene Errera, Louisa Wickham, Sidath E Liyanage, Mostafa Elgohary, Praveen J Patel, Josealain Sahel, Michel Paques, Eric Ezra, Paul SullivanAbstract:Purpose: To describe small hyperreflective areas using spectral-domain optical coherence tomography (SD-OCT) imaging in eyes that have had Silicone Oil tamponade. Methods: Retrospective case series of 11 eyes of 11 patients. The authors retrospectively identified patients who underwent vitrectomy and Silicone Oil tamponade secondary to a rhegmatogenous retinal detachment (nine patients), panuveitis with retinal necrosis (one patient), or recurrent full-thickness macular hole surgery (one patient) who had manifestations of Silicone Oil emulsion on SD-OCT imaging. Patients were monitored during the postoperative period by clinical examination and using SD-OCT. A model eye in which emulsified Silicone Oil had been injected in the anterior chamber was used to obtain anterior segment SD-OCT images for comparison. Results: The mean age of our patients was 50 years (range, 39–76 years). In eight eyes, the SD-OCT examination was carried out after Silicone Oil removal, and in three eyes, the SD-OCT examination was carried out with the Oil in situ. Of the nine eyes treated for rhegmatogenous retinal detachment, five had a relieving retinectomy for advanced anterior proliferative vitreoretinopathy or for traumatic retinal incarceration (one eye). The eye treated for full-thickness macular hole had a vitrectomy, internal limiting membrane peel, and Silicone Oil injection for recurrent macular hole. Ten eyes showed hyperreflective, spherical, tiny droplets using SD-OCT imaging. These were thought to represent Silicone Oil droplets intraretinally or underneath epiretinal membranes, and one eye showed hyperreflective areas subretinally (retina detached). One additional patient was found to have tiny intravitreal Silicone Oil droplets after Silicone Oil removal. Similarly, the Silicone Oil appeared as multiple hyperreflective spherical droplets as detected by SD-OCT. Anterior segment studies of Silicone Oil emulsification in the experimental model revealed a similar appearance to that seen with in vivo SD-OCT imaging. Conclusion: The authors have found small hyperreflective areas intraretinally, subretinally, and underneath epiretinal membranes on SD-OCT in eyes that have had Silicone Oil tamponade for a variety of indications. The authors have seen a similar appearance when Silicone Oil emulsification is examined in vivo. The authors conclude that the hyperreflective areas are likely (but not certain) to be very small bubbles of emulsified Silicone. Further studies are required to determine the incidence, clinicopathologic, and functional significance of probable Silicone Oil emulsification and deposition within the retinal layers.
Louisa Wickham - One of the best experts on this subject based on the ideXlab platform.
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using spectral domain optical coherence tomography imaging to identify the presence of retinal Silicone Oil emulsification after Silicone Oil tamponade
Retina-the Journal of Retinal and Vitreous Diseases, 2013Co-Authors: Mariehelene Errera, Louisa Wickham, Sidath E Liyanage, Mostafa Elgohary, Praveen J Patel, Josealain Sahel, Michel Paques, Eric Ezra, Paul SullivanAbstract:Purpose: To describe small hyperreflective areas using spectral-domain optical coherence tomography (SD-OCT) imaging in eyes that have had Silicone Oil tamponade. Methods: Retrospective case series of 11 eyes of 11 patients. The authors retrospectively identified patients who underwent vitrectomy and Silicone Oil tamponade secondary to a rhegmatogenous retinal detachment (nine patients), panuveitis with retinal necrosis (one patient), or recurrent full-thickness macular hole surgery (one patient) who had manifestations of Silicone Oil emulsion on SD-OCT imaging. Patients were monitored during the postoperative period by clinical examination and using SD-OCT. A model eye in which emulsified Silicone Oil had been injected in the anterior chamber was used to obtain anterior segment SD-OCT images for comparison. Results: The mean age of our patients was 50 years (range, 39–76 years). In eight eyes, the SD-OCT examination was carried out after Silicone Oil removal, and in three eyes, the SD-OCT examination was carried out with the Oil in situ. Of the nine eyes treated for rhegmatogenous retinal detachment, five had a relieving retinectomy for advanced anterior proliferative vitreoretinopathy or for traumatic retinal incarceration (one eye). The eye treated for full-thickness macular hole had a vitrectomy, internal limiting membrane peel, and Silicone Oil injection for recurrent macular hole. Ten eyes showed hyperreflective, spherical, tiny droplets using SD-OCT imaging. These were thought to represent Silicone Oil droplets intraretinally or underneath epiretinal membranes, and one eye showed hyperreflective areas subretinally (retina detached). One additional patient was found to have tiny intravitreal Silicone Oil droplets after Silicone Oil removal. Similarly, the Silicone Oil appeared as multiple hyperreflective spherical droplets as detected by SD-OCT. Anterior segment studies of Silicone Oil emulsification in the experimental model revealed a similar appearance to that seen with in vivo SD-OCT imaging. Conclusion: The authors have found small hyperreflective areas intraretinally, subretinally, and underneath epiretinal membranes on SD-OCT in eyes that have had Silicone Oil tamponade for a variety of indications. The authors have seen a similar appearance when Silicone Oil emulsification is examined in vivo. The authors conclude that the hyperreflective areas are likely (but not certain) to be very small bubbles of emulsified Silicone. Further studies are required to determine the incidence, clinicopathologic, and functional significance of probable Silicone Oil emulsification and deposition within the retinal layers.
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immunopathology of intraocular Silicone Oil enucleated eyes
British Journal of Ophthalmology, 2007Co-Authors: Louisa Wickham, Riaz H Y Asaria, Robert A Alexander, Phil Luthert, David G CharterisAbstract:Aims: To characterise the distribution of Silicone Oil in ocular tissues in globes enucleated after complicated retinal detachment, and to document the distribution and nature of any associated inflammatory response. Method: 9 enucleated globes that had previously undergone retinal detachment surgery with Silicone Oil and 7 control globes that had undergone enucleation after retinal detachment surgery (n = 2) or ocular trauma (n = 5) were studied. Sections were histologically examined using light microscopy to document the distribution of Silicone Oil in ocular tissues. Immunohistochemical analysis was carried out using the ABC technique and a panel of monoclonal and polyclonal antibodies. Electron microscopy was undertaken to observe the penetration of Silicone Oil in the trabecular meshwork of the anterior chamber drainage angle. Results: Silicone Oil was distributed throughout the globes—notably in the iris, ciliary body, retina, trabecular meshwork and epiretinal membranes. Focal areas of intraretinal Silicone were associated with disorganised retinal architecture, retinectomy sites or subretinal Oil. The distribution of macrophages was closely related to the distribution of Silicone Oil. T and B lymphocytes were not associated with Silicone Oil unless additional pathology was also present—for example, cyclitic membrane or uveitis. One of the nine eyes had Silicone Oil present in the optic nerve. In the control globes, the inflammatory response was mediated primarily by macrophages and T lymphocytes, and was less marked than that observed in the Silicone Oil globes. Conclusion: This study shows that Silicone Oil may be sequestered in varied ocular tissues and is associated with localised inflammation mediated by macrophages.
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immunopathology of intraocular Silicone Oil retina and epiretinal membranes
British Journal of Ophthalmology, 2007Co-Authors: Louisa Wickham, Riaz H Y Asaria, Robert A Alexander, Phil Luthert, David G CharterisAbstract:Aims: To determine the inflammatory response in retina and epiretinal membranes after intraocular Silicone Oil tamponade. Methods: 14 proliferative vitreoretinopathy (PVR) epiretinal membranes, 33 retro-Oil epiretinal membranes, 19 retinectomies, 14 retro-Oil retinectomies and 37 idiopathic epiretinal membranes (controls) underwent immunohistochemical analysis using the avidin–biotin complex technique and a panel of monoclonal and polyclonal antibodies. The number of positive cells counted in five 0.5 mm diameter fields of immunohistochemical sections was graded on a score of 1–4. Results: Macrophage cell counts were significantly greater in membranes with a history of exposure to Silicone Oil (p<0.001). An inflammatory response could be observed within 1 month of Silicone Oil exchange, and the intensity seemed to be unrelated to the duration of exposure. Macrophages were confined to epiretinal membranes on the surface of retinectomy specimens in 10 of 14 cases and intraretinal macrophages were observed only in specimens with gliotic retina. T and B lymphocytes were rarely seen in the specimens examined. Marked glial cell up regulation was observed in 11 of 16 retinectomy specimens and in 8 of 11 retro-Oil retinectomies. Glial cell content was variable in the membranes, but there was a trend of increased presence after exposure to Silicone Oil. Conclusion: This study has shown that the use of Silicone Oil is accompanied by an inflammatory reaction, primarily mediated by bloodborne macrophages. This response can be observed within 1 month of Silicone Oil injection and continues after Silicone Oil removal. Retinal surgeons should be aware of the potential secondary effects of intraocular Silicone Oil when they are considering its use (and removal) in vitreoretinal surgery.