Office-Based 25-Gauge Needle Revision of Closed Peripheral Iridotomy in Aphakic Silicone Oil-Filled Eyes

We present a novel office-based technique using a 25-gauge needle to reopen closed peripheral iridotomies in aphakic eyes filled with silicone oil.

We use a 25-gauge needle to enter the clear cornea and reopen the closed peripheral iridotomy, allowing for aqueous humor and silicone oil to escape and relieve elevated intraocular pressure.

This minimally invasive office-based approach provides immediate relief of elevated intraocular pressure due to silicone oil-induced pupillary block, avoiding the need for more invasive surgical intervention.

Our technique is a simple, cost-effective, and accessible way to combat silicone-oil induced pupillary block in aphakic patients and may be a good first-line approach for a difficult-to-manage condition.