الفهرس 
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Abstract
Endothelial cell density (ECD) and morphology are important because they facilitate the assessment of the functional reserve of the endothelium in patients before any intraocular surgery. The goal of this study was to measure the changes in ECD using non-contact specular microscopy in eyes that underwent PPV with silicone oil (SO) tamponade.
The study was conducted on 24 patients who underwent pars plana vitrectomy with silicone oil tamponade in the memorial institute for ophthalmic researches (MIOR). The included patients were assigned into two groups; 12 patients underwent pars plana vitrectomy and silicone oil injection (group 1) and 12 patients underwent combined phaco-vitrectomy & SO injection (group 2).
There was no statistically significant difference found between the two studied groups regarding the amount of change (mean difference) in BCVA at the 1st week and 1st month, while there was a statistically significant increase in the amount of change of BCVA in group 1 than in group 2 at the 3rd month with p-value = 0.005. The comparison between both groups regarding the amount of change in IOP at the 1st month and 3rd month showed the insignificant difference between them.
There was no statistically significant difference found between the two studied groups regarding MCD at the 1st week, 1st month, and 3rd month. Also, there was a statistically significant decrease in the MCD in group 1 and group 2 at the 3rd month than at the 1st week with p-value < 0.001 and 0.007 respectively. The comparison between both groups regarding the amount of change in MCD at the 1st month and 3rd month showed a higher decrease in group 2 than in group 1 but did not reach a statistically significant differences with p-value = 0.204 and 0.686, respectively.
In the present study, there was no statistically significant difference found between the two studied groups regarding CCT at the 1st week, 1st month, and 3rd month postoperative. Also, there was a statistically significant increase in the CCT in group 1 and group 2 in the 3rd month than at 1st week with p-value = 0.044 and 0.006 respectively. The comparison between both groups regarding the amount of change in CCT at 1st month and 3rd month showed a higher increase in group 2 than in group 1 but did not reach a statistically significant difference with p-value = 0.140 and 0.273, respectively.
There was no statistically significant difference found between the two studied groups regarding CV at the 1st week, 1st month, and 3rd month postoperative with p-value = 0.280, 0.669, and 0.506 respectively. Also, there was a statistically significant increase in the CV in group 1 and group 2 at the 3rd month than at the 1st week. The comparison between both groups regarding the amount of change in CV at the 1st month and 3rd month showed a statistically significant higher increase in group 2 than in group 1.
There was no statistically significant difference found between the two studied groups regarding HEX at the 1st week, 1st month, and 3rd month postoperative. Also, there was a statistically significant decrease in the HEX in group 1 and group 2 at the 3rd month than at the 1st week. The comparison between both groups regarding the amount of change in HEX at the 1st month and 3rd month showed a higher decrease in group 2 than in group 1 but did not reach a statistically significant difference.
In conclusion, the procedure of pars plana vitrectomy (PPV) with silicone oil (SO) injection is associated with corneal endothelial cell changes in the form of EC loss, polymegathism, and pleomorphism. The postoperative change in MCD, CCT, and Hexagonal Cell Percentage (HEX) did not differ significantly between pars plana vitrectomy and silicone oil injection and combined phaco-vitrectomy & SO injection. However, there was a significantly higher increase in CV after combined phaco-vitrectomy than pars plana vitrectomy alone.
CONCLUSION
• The procedure of pars plana vitrectomy (PPV) with silicone oil (SO) injection is associated with corneal endothelial cell changes in the form of EC loss, polymegathism, and pleomorphism. There was a statistically significant decrease in the MCD after PPV & SO injection with or without phacoemulsification. The postoperative change in MCD, CCT, and HEX (pleomorphism) did not differ significantly between pars plana vitrectomy with silicone oil injection (Group1) and combined phaco-vitrectomy with SO injection (group 2) because we compared statistics results only postoperatively to remove operation itself as a confounding factor. However, there was a significantly higher increase in CV (polymegathism) after combined phaco-vitrectomy than pars plana vitrectomy alone. So, a Combined phaco-vitrectomy operation can be done as a routine in cases of retinal detachment but we recommend SO removal after achieving the proposed tamponading action of SO to avoid SO keratopathy.
• Our study had some limitations. Because of the small number of patients in the study, the results may be more significant when more patients are added. The included patients were only tracked for three months and results may be more significant if the follow-up period is longer.
RECOMMENDATIONS
• It is recommended to further compare between results of pars plana vitrectomy with silicone oil injection and combined phaco-vitrectomy with SO injection among larger sample size study and longer follow-up period.
• Multicenter study would be beneficial for obtaining more accurate results.
• Blind-randomization of patients between the two groups is needed in further studies.