Introduction
Hello, everyone! This is Dr. Mário Bulla and welcome to the Retina and Vitreous channel. This is your space to clarify all your doubts about the retina. We get a lot of questions from you, our followers, and today we're going to answer a common question: if I have a cataract and silicone oil in my eye, do I need to operate on both? Let's explore this question in detail.
Understanding the Situation
First of all, it's important to remember that each case is unique and the final decision on treatment should be made by your doctor after a thorough assessment. This article aims to provide general information to help you better understand this situation.
What is Silicone Oil?
Silicone oil is used as an “internal tamponade” in vitrectomy surgery, which is performed to treat retinal detachment or other serious conditions. It helps keep the retina in place while it heals. Unlike gas, which is absorbed by the body within a month or two, silicone oil remains in the eye until it is surgically removed.
What is Cataract?
A cataract is an opacification of the crystalline lens, the natural lens of the eye, which impairs vision. It can develop naturally with age or be accelerated by factors such as the presence of silicone oil or gas in the eye after a vitrectomy.
When Cataracts and Silicone Oil Are Present Together
It is common to find patients with a cataract and silicone oil in the eye. The presence of both requires a careful approach to decide the best time for surgery.
#### Cataract Surgery and Silicone Oil Removal: What's the Order?
In general, the recommendation is to treat both problems simultaneously in a single surgery. This involves removing the cataract and replacing the lens with an artificial intraocular lens, and then removing the silicone oil.
Some doctors prefer to treat the cataract first and remove the silicone oil in a separate procedure. This approach may be necessary if there are concerns that the retina is not stable enough without the support of the silicone oil.
Surgical Procedure
1. *Cataract Removal:* The surgery begins with a small incision in the cornea to remove the opaque lens and implant the intraocular lens.
2. *Silicone Oil Removal:* Using the same incisions as the vitrectomy, a liquid called BSS (balanced salt solution) is inserted into the eye. The BSS helps to expel the silicone oil, which is removed using small instruments.
Post-operative
After the silicone oil has been removed, the eye is filled with BSS, which is slowly replaced by the eye's natural aqueous humor. In some cases, it may be necessary to fill the eye with air or gas to ensure that the retina remains stable.
Special Considerations
There are situations in which silicone oil cannot be removed, such as when there is a high risk of the retina detaching again. In these cases, the oil can be left in the eye for a longer period. However, most patients will eventually have the oil removed.
Conclusion
The decision to operate on the cataract and remove the silicone oil simultaneously or in separate procedures depends on several factors, including the stability of the retina and the general health of the eye. Your ophthalmologist is the best resource for determining the most appropriate treatment plan for your specific case.
If you have any more questions on this subject, leave a comment below. Don't forget to like the video, subscribe to the channel and see you in the next Retina e Vítreo video!
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This video and its comments are not a substitute for a doctor's consultation and are for educational purposes only. They should not be used for decision-making purposes, which requires a face-to-face consultation with a specialist doctor.
Author:
Dr. Mário César Bulla
Cremers 28120
Ophthalmologist - Retinologist
www.clinicabulla.com.br
www.especialistaemretina.com.br
Instagram: @retina.bulla
Video URL: • Operar catarata com ól...
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0:00 Cataract and silicone oil, do you need to operate on both?
1:10 What is silicone oil used for?
1:36 Difference between oil and gas?
1:50 Cataract acceleration.
2:40 Combined surgery: remove oil and cataract