High-performance oil absorption micro-fibers-tackling the dilemma of emulsification arising from the residual Silicone oil in vitreoretinal surgery

Abstract

<p><strong>Purpose </strong>: Intraocular inertness and transparency of Silicone oil (SilOil) make it well-tolerated vitreous substitute for handling complicated retinal detachment (RD) in vitreoretinal surgery. However, the presence of residual SilOil is inevitable thereby causing the most worrying postoperative complication of emulsification. To address this challenge, we developed tailored-made micro-fibers (MF) with high-performance oil-absorption properties that can effectively remove residual liquid-form SilOil and thus diminish emulsification.</p><p><strong>Methods </strong>: MF were fabricated via droplet microfluidics, followed by dual crosslinking steps and hydrophobic surface treatment. Characterizations of MF were performed to measure their porosity, hydrophobicity, oil absorption capacity, and biocompatibility. To evaluate the performance of the MF in removing SilOil, micro-incision vitreoretinal surgeries were performed in an <em>ex vivo</em> porcine eye model. Three conventional clinically used surgical techniques, including fluid-air exchange (FAX), passive drainage (PD), and bulk SilOil removal (BSR) were set as control groups (N=11). The volume of liquid-form residual SilOil was quantified by fourier-transform infrared spectroscopy, whilst the emulsified SilOil was indicated by droplet distribution profile from coulter counter. One-way ANOVA followed by Bonferroni test was used for statistical analysis.</p><p><strong>Results </strong>: The porosity of MF is up to 86.9% and most of micro-pores have the diameter less than 1 µm. MF of 1 g can absorb 12.17± 2.25 g SilOil of 1000 cSt, with the absorption rate up to 0.068 ± 0.015 gg^-1s^-1. No significant difference was observed between the MF group and control group in cell viability after incubation with ARPE-19 cells up to 48 hours (P=0.05). Compared with control groups, a significantly less amount of residual SilOil (over 79%) of liquid form was identified in MF group (P=0.001). In addition, the intraocular application of MF did not increase the risk of emulsification of residual SilOil, as evidenced by the distribution profile of emulsified droplets in the washout of vitreous cavity (P=0.05).</p><p><strong>Conclusions </strong>: We developed high-performance oil absorption MF with high porosity and good biocompatibility, to more effectively remove SilOil of liquid form, which could reduce complications associated with the emulsified SilOil.</p>