Anatomical results and complications after silicone oil removal

Abstract

The aim of the report was to evaluate anatomical results and intra and postoperative complications after silicone oil (SIO) removal.Methods: Retrospective, interventional study evaluating consecutive cases with ambulatory SIO removal after vitrectomy for complex retinal detachments. The anatomical result was the main followed parameter. Intra and postoperative complications and also intraocular pressure changes were evaluated. Cases were followed-up for at least 12 months. Results: A total of 98 consecutive cases were reviewed. The main duration of oil endotamponade was 5.46 months (3–16 months). In 15 cases (15.30%) signs of SIO emulsification were noted at the time of removal. A stable anatomical result after SIO removal was obtained in 94 out of 98 cases (95.91%). Retinal detachment recurrence appeared in first month postoperatively (1 case) and between the 3rd and 4th month postoperatively (3 cases). Main indications for 5000cs SIO endotamponade during ambulatory 23G vitrectomy were represented by proliferative vitreoretinopathy (PVR) (78 cases - 79.59%), proliferative diabetic retinopathy (17 cases - 17.34%) and giant retinal tears (3 cases - 3.06%). 29 eyes (29.59%) were pseudophakic at primary surgery. However, most phakic eyes showed cataract appearance and progression during SIO endotamponade and also after SIO removal. Intraocular pressure significantly decreased after SIO removal with the occurrence of various choroidal detachments in 8 cases (8.16%), resolving spontaneously within the first week postoperatively. Conclusions: In our experience, the retinal detachment recurrence rate after SIO removal was 4.08%. This promising anatomical result confirms the need for an accurate primary surgery and also for a safe moment of SIO removal according to the severity of primary pathology.

Retinal Nerve Fiber Layer Changes after Intraocular Silicone Oil Tamponade in Rhegmatogenous Retinal Detachment

“…In a recent macula-on retinal detachment study, higher IOP during SO endotamponade was the biggest risk factor for vision loss significantly different at pre- and post SO removal ( p = 0.08). This result is similar to the study by Brănişteanu et al (2017), who reported a decrease in IOP post SO removal [ 32 ].…”

“…Several reports also showed that the first sign of SO emulsification can be found within the first 3 months post-operatively, or even 4 weeks after endotamponade. Due to a large number of cases of SO emulsification within 1 year, the consensus recommended that removal must be carried out within this time interval [ 32 , 33 ]. The mean IOP for all age groups and durations of SO application did not affect pre removal measurements or follow up.…”

Intraocular pressure changes during and after silicone oil endotamponade (Review)

“…In a retrospective evaluation of 98 consecutive cases with complex retinal detachments that underwent 23G vitrectomy and high viscosity SIO endotamponade (Oxane ® 5700) we noted significant IOP changes during both SIO endotamponade and after SIO removal ( 8 ). In 52 out of 98 cases (53.06%) with no preexisting glaucoma, IOP increased over 21 mmHg requiring topical antiglaucomatous medication during endotamponade.…”

“…Many complications have been associated with SIO endotamponade. While refractive change is a perturbing yet harmless feature during endotamponade, more severe complications may occur as macular pucker, cystoid macular edema, and rubeosis iridis ( 8 ). Long-standing SIO endotamponade is associated with significant ocular complications such as cataract formation, corneal decompensation, band keratopathy, and orbital leakage ( 9 , 10 ).…”

Effectiveness of different silicone oil remove methods after vitrectomy and light silicone oil tamponade in elderly patients

“…The two groups differed significantly in the incidence of complications (χ 2 =4.2787, P=0.0386). None of the affected eyes were complicated with transient intraocular hypotension (7), vitreous hemorrhage or endophthalmitis.…”