Outcome of Temporary Silicone Oil Tamponade in Complex Rhegmatogenous Retinal Detachment

Abstract

Purpose

To evaluate the anatomic and visual outcomes and complications of temporary silicone oil (SO) retinal tamponade in patients with complex rhegmatogenous retinal detachments (RD).

Methods

The retrospective study included 100 eyes of 93 consecutive patients. Indications for the use of SO were proliferative vitreoretinopathy (PVR) (30 eyes), difficult RD (30 eyes), giant retinal tears (17 eyes), RD after penetrating trauma (14 eyes), and macular holes in highly myopic eyes (9 eyes). Vitrectomy surgery was performed with 5000-centistoke SO as the retinal tamponade. All eyes underwent prophylactic 360° retinopexy at the time of the retinal reattachment operation. The mean duration of SO tamponade was 26.4 weeks, with a mean follow-up of 67.5 weeks after removal of SO.

Results

In 6 of 100 eyes (6%), the retina redetached after removal of SO. Including the successfully reoperated eyes, the final anatomic success rate was 96%. Other complications were cataract (61%), increased intraocular pressure (13%), hypotony (4%), keratopathy (4%), intravitreal hemorrhage (1%), and suprachoroidal hemorrhage (1%). Corespondence analysis demonstrated that redetatchment and hypotony were associated with PVR and trauma. Overall, good visual outcome (20/200 or better) was achieved in 51% of the whole study group, and in 70.6% of eyes with giant tears, 62.1% of eyes with difficult RD, 44.8% of eyes with PVR, 33.3% of eyes with macular holes, and 28.6% of eyes with trauma (p=0.0382). Logistic regression analysis identified initial visual acuity of 20/200 or better as a factor associated with good visual outcome and occurrence of retinal redetachment/hypotony and old age (≥50 years) as factors negatively associated with good visual outcome.

Conclusions

The low redetachment rate might be due to prophylactic 360° retinopexy. Giant tears had the best visual outcome. Redetachment/hypotony had a negative impact on achievement of good visual outcome and were associated with PVR and trauma.