Evaluation of long-term outcomes associated with extended heavy-silicone oil use for the treatment of inferior retinal detachment

Abstract

To evaluate macular status with optical coherence tomography (OCT) in eyes that underwent pars plana vitrectomy (PPV) and heavy-silicone oil (HSO) endotamponade for the treatment of rhegmatogenous retinal detachment (RRD) with inferior breaks. Twenty eyes of 20 patients who have RRD with inferior breaks included in the study. Oxane HD was used as an intraocular tamponade for all surgeries. Postoperatively, anatomic reattachment, macular status using OCT imaging, and any long-term complications were evaluated. The mean age was 60.4 ± 11.2 years (range, 37–83). The duration of HSO endotamponade was 15.3 ± 11.0 months (range, 6–48) with some postoperative complications such as HSO emulsification, intraocular pressure elevation, and epiretinal membrane (ERM) formation. Mean follow-up time was 19.5 ± 10.5 months (range, 10–59) after HSO removal or ERM surgery. Primary reattachment was achieved in 90% of eyes and the success rate was 100% with further interventions. Ellipsoid zone (EZ) was continuous in 13 of 20 eyes in which OCT imaging performed as well as the fellow eye. PPV and heavy-silicone oil injection for the treatment of eyes with RRD from inferior break(s) have a good long-term EZ continuity. ERM formation and its removal do not affect EZ.

Optical Coherence Tomography Findings in Rhegmatogenous Retinal Detachment: A Systematic Review

“…Horozoglu et al found that the long-term use of heavy silicone oil for the treatment of retinal detachment resulted in a good anatomical reattachment of the retina with good ellipsoid zone continuity and foveal thickness. However, extended use of heavy silicone oil increased the rate of epiretinal membrane formation [ 36 ].…”

“…Moreover, monitoring of retinal thinning using SD-OCT may support the decision to remove silicone oil with the correct timing in order to minimize the potential thinning effect on the retina [ 32 , 33 ]. Extended use of heavy silicone oil is associated with an increased risk of ERM formation [ 36 ]. It is likely that the retina is more susceptible to damage from silicone oil than the choroid since silicone oil makes contact only with the retina.…”

Emulsification of Silicone Oils: Altering Factors and Possible Complications—A Narrative Review

“…More frequent emulsification has been reported with their use than with PDMS alone, reaching up to 65%. Studies show the appearance of emulsification with HSO much faster than with SO-as early as 3 weeks after treatment [16,17]. It is believed that the inflammation induced by HSO induces emulsification, where inflammatory cells behave as surfactants [9].…”

Vitreous Substitutes from Bench to the Operating Room in a Translational Approach: Review and Future Endeavors in Vitreoretinal Surgery

“…Furthermore, another challenge to the use of PDMS is that it is buoyant, having a specific gravity of 0.97 g/mL, whereas the vitreoretinal surgeon often has to treat inferiorly located detachments, PVR, and retinal tears [ 94 ]. To overcome this problem, PDMS and SFAs have been combined to take advantage of the high viscosity of SiO and the high specific gravity of SFAs to generate a HSiO as discussed below.…”