A four-year retrospective surgical case series examining postoperative complications following removal of silicone oil (ROSO) scored using the Complications in Retinal Detachment Surgery (CORDS) Severity Classification Tool

Abstract

Purpose Silicone oil (SO) tamponade and the removal of silicone oil (ROSO) in the management of complex retinal detachments carry well-defined postoperative complications. Our objective was to classify and grade complications following ROSO using the Complications of Retinal Detachment Surgery (CORDS) Severity Classification and to propose a unifying global complication score. Methods A single-centre retrospective case series of eyes undergoing ROSO was performed between 2018–2022. All patient data was collected with one-year follow-up. Best recorded visual acuity (BRVA, LogMAR), intraocular pressure (IOP, mmHg) and complications were recorded from electronic patient records (EPR). Complications were scored using the CORDS Severity Classification. A Modified Global Complication Score (MGCS) was calculated for our study cohort. Results SO was removed from 46 eyes with a mean tamponade duration of 8.2±6.61 months. A total of 88 CORDS items were recorded over the 12-months. Serious complications included anterior displacement of SO (12.5%), retinal re-detachment (5.68%), raised IOP requiring treatment (14.8%), severe loss of vision (18.9%), corneal decompensation (5.68%) and phthisis (2.27%). There was a statistically significant difference in mean severity scores across follow-up timepoints (F[3,44]=3.06, P=0.04) with a difference observed between the ‘3-month’ and ‘6-month’ timepoints (mean difference +7.71, 95%CI +0.470 to +15.0, P=0.03). The MGCS was 9.52% for our cohort. Conclusion Postoperative complications following ROSO are common with high-severity complications, such as secondary glaucoma, corneal decompensation and phthisis, emerging after six months. The MGCS provides a single unifying global score that sets a benchmark for comparison between future retinal studies.