“Ocular hypertension after silicone oil removal: A risk factor analysis”

Abstract

Purpose

To evaluate the incidence and risk factors associated with ocular hypertension following removal of silicone oil (ROSO) in patients previously treated for various vitreoretinal conditions.

Methods

This retrospective cohort study was conducted on 93 eyes of 93 patients who underwent ROSO at Piero Palagi Hospital, Florence, between September 2021 and April 2024. Eyes with prior glaucoma surgery or insufficient follow-up (<9 months) were excluded. Demographic, anatomical, and clinical data—including axial length (AL), preoperative intraocular pressure (IOP), lens status, silicone oil (SO) tamponade duration, emulsification in the anterior chamber, and history of previous vitreoretinal surgery—were collected. Univariate and multivariate logistic regression analyses were performed to identify predictors of postoperative ocular hypertension, defined as IOP ≥ 21 mmHg during follow-up.

Results

Ocular hypertension occurred in 27 out of 93 eyes (29%) during the follow-up. However, at 9 months follow-up, only 16 out of 93 eyes (17.2%) still required IOP-lowering medications. In multivariate analysis, risk factors significantly associated with ocular hypertension included emulsification of SO in the anterior chamber (OR, 4.32; 95% CI, 1.61–11.56; p = 0.002), higher preoperative IOP (OR, 1.74; 95% CI, 1.25–2.59; p = 0.004), longer axial length (OR, 1.49; 95% CI, 1.05–2.45; p = 0.032), and longer tamponade duration (OR, 1.62; 95% CI, 1.04–2.88; p = 0.041).

Conclusion

Ocular hypertension is a relatively common complication after ROSO. Factors associated with increased risk include anterior chamber SO emulsification, higher preoperative IOP, greater axial length, and longer tamponade duration. Identifying these patients preoperatively may support closer postoperative monitoring and improve visual outcomes.