Primary Silicone Oil Tamponade Without Retinopexy in Highly Myopic Eyes With Central Macular Hole Detachments

Abstract

Vitrectomy plus primary silicone oil tamponade without endophotocoagulation is an effective method to treat central macular hole detachments in highly myopic eyes.

1000 cSt silicone oil vs heavy silicone oil as intraocular tamponade in retinal detachment associated to myopic macular hole

“…Thereafter, Lu et al compared PPV plus gas and laser, vs gas and no laser vs silicone and no laser, favoring the first with a success rate of 93% vs 58% and 57% respectively for the others, suggesting a key role for laser in the determination of the anatomical results [21]. However, Sholda et al presented a series of 11 eyes in which no photocoagulation of perifoveal retina was executed, with a 100% reattachment rate and good functional results [16]. The introduction of silicone oil seemed to improve the average success rate of surgery, although remaining substantially far from ideal in larger series.…”

“…Silicone oil tamponade was introduced in macular hole surgery as an option for patients unable to maintain postoperative positioning, as required for gas-filled eyes [10][11][12]; it has also been suggested in the treatment of persistent idiopathic macular hole [13][14][15]. The use of silicone oil in RD associated to MMH has been proposed as a primary approach, with promising anatomical and functional results [16]. Recently, some authors have demonstrated that heavy silicone oil (HSO) conforms better than silicone oil (SO) to the foveal depression, mainly in the upright position, suggesting a role as a vitreous substitute in this kind of surgery [17].…”

Prevention and control of proliferative vitreoretinopathy: primary retinal detachment surgery using silicone oil as a planned two-stage procedure in high-risk cases

“…Its use in primary reattachment procedures has been restricted to cases of giant retinal tears, although good results with silicone oil for macular hole detachments in staphylomas of highly myopic eyes have also been reported. 19,20 Our study demonstrates that by adopting a planned two-stage approach using silicone oil in other high-risk categories, an improved primary reattachment rate can be achieved compared to that reported in other series involving similar cases. Using this approach the option to remove the silicone can be exercised at a later stage and in a planned manner.…”

Is There a Role for Long-Term Silicone Oil Tamponade for More than Twelve Months in Vitreoretinal Surgery?

“…Historically, silicone oil tamponade was mainly intended for complex retinal detachments [3] with aggravating factors such as proliferative vitreoretinopathy (PVR) [4,5] and tractional retinal detachments associated with proliferative diabetic retinopathy [6,7]. However, indications for the use of silicone oil expanded over time to include macular holes [8,9], myopic foveoschisis [10,11], optic disc pits [12], uveitis [13,14], acute retinal necrosis [15], hypotony [14] and trauma [16]. With such an ever-increasing number of patients eligible, silicone oil-related issues including the management of its complications have become relevant factors in the daily practice of vitreoretinal specialists and general ophthalmologists alike.…”