Fig. 7.1
Postoperative change of artificial lens implantation. (a) Axial T2-weighted MR image shows the normal lens of right side is absent with a small isointense strip found in the corresponding region; (b) axial nonenhanced CT image (another case) shows bilateral crystalline lenses are absent and small hyperdense strips are found in the corresponding regions
7.1.4 Evaluation
The normal lens is absent with a small strip in the corresponding region. The diagnosis and differential diagnosis is easy with consideration of medical history.
7.2 Postoperative Change of Vitrectomy
7.2.1 Pathology Features
- 1.
Vitrectomy combined with gas or silicone oil tamponade is performed in patients for variable reasons such as complicated retinal detachment, vitreous hemorrhage, and macular diseases.
- 2.
Cavum vitreum is usually filled with a small amount of fluid.
7.2.2 Imaging Protocols
- 1.
Imaging is not necessary after vitreous body excision. If retinal detachment recurrence is suspected, fundus oculi cannot be observed due to turbidity of dioptric media or measurement of axis oculi is needed, ultrasound, MRI, or CT can be performed.
- 2.
Ultrasound, as the first choice in clinical practice, is performed easily, but measurement of axis oculi is not accurate enough when cavum vitreum is filled with silicone oil.
- 3.
MRI can demonstrate the postoperative change of vitrectomy and retinal detachment clearly. The accuracy of axis oculi measurement is not disturbed by silicone oil.
- 4.
The role of CT is similar to that of MRI with disadvantage of radiation.
7.2.3 Imaging Findings
- 1.
MRI findings: After vitrectomy combined with gas or silicone oil tamponade, the silicone oil filled in cavum vitreum shows high or slightly high signal intensity (Fig. 7.2a–c) on T1WI, high signal intensity on T2WI, and low or no signal intensity on fat saturation sequence (Fig. 7.2d), and no enhancement after contrast administration. In cases of vitrectomy combined with gas tamponade, the gas in cavum vitreum shows low signal intensity both on T1WI and T2WI.
- 2.
CT findings: Silicone oil in the cavum vitreum displays as homogenous high density with 100 CT Hu. The fluid in the cavum vitreum is low or slightly low density, and the gas in the cavum vitreum is low density.
Fig. 7.2
Post-vitrectomy combined with silicone oil tamponade. (a) On axial T1-weighted MR image, the silicone oil in cavum vitreum shows homogeneous hyperintense signal with fluid-to-fluid level in posterior region. (b) On axial T2-weighted MR image, the silicone oil filled in cavum vitreum shows homogeneous high signal intensity with fluid-to-fluid level in the posterior area. (c) On oblique sagittal T1-weighted MR image, the silicone oil filled in cavum vitreum shows homogeneous high signal intensity with bracket-shaped hyperintense fluid accumulation in the upper posterior part and very low signal intensity of chemical shift artifacts in the inferior part. (d) On axial contrast T1-weighted MR image with fat saturation, the signal of silicone oil in the cavum vitreum is suppressed with fluid-to-fluid level in the posterior area
7.2.4 Evaluation
Postoperative change of vitreous body excision is easy to discriminate from other lesions due to its characteristic homogenous abnormal signal intensity in the vitreous body.
7.3 Section Postoperative Change of Scleral Buckling Surgery
7.3.1 Pathology Features
- 1.
Scleral buckling is one of the common surgery treatments for rhegmatogenous retinal detachment. Pressurized material or buckle is put outside the sclera, which can compress the sclera to fit retinal neuroepithelium and pigment epithelium closely and to reduce the retina traction by vitreous body.
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