Silicone Oil Tamponade Effect on Macular Layer Thickness and Visual Acuity

Abstract

Purpose: To evaluate the influence of silicone oil (SO) tamponade on retinal layers thickness and visual acuity in patients who underwent pars plana vitrectomy for rhegmatogenous retinal detachment. Methods: This is a retrospective case series of consecutive patients who underwent pars plana vitrectomy for rhegmatogenous retinal detachment with SO tamponade. Visual acuity and central macular thickness were measured with SO and at least a month after SO removal (SOR). Patients with insufficient or poor-quality images or macular pathologies such as macular edema or epiretinal membranes were excluded. Results: Forty-one patients with an average age of 56.1 ± 15.2 years were included, and 54% presented with fovea ON. Average tamponade duration was 151 ± 54 days. Central macular thickness of the operated eye increased from 249 ± 50 µm before to 279 ± 48 µm after SOR (P < 0.001), compared with 281 ± 21 µm of the fellow eye (P < 0.001). A mean change of 26 µm was found in the internal layers (P < 0.001). Visual acuity improved from 0.85 ± 0.97 logarithm of the minimal angle of resolution (logMAR; Snellen 20/140) with SO tamponade to 0.34 ± 0.28 logMAR (Snellen 20/43) after SOR (P < 0.001). For patients with fovea ON and without significant cataract, visual acuity was 0.19 ± 0.16 logMAR (Snellen 20/30) at presentation, 0.59 ± 0.41 logMAR (Snellen 20/80) with SO (P = 0.005), and 0.18 ± 0.15 logMAR (Snellen 20/30) after SOR (P = 0.003). Conclusion: Silicone oil tamponade causes a transient decrease in central macular thickness, mainly in the inner layers. After SOR, central macular thickness resembles to the fellow eyes. The mechanism for this effect is unclear, but apparently has no influence on final visual acuity.

Retinal Changes before and after Silicone Oil Removal in Eyes with Rhegmatogenous Retinal Detachment Using Swept-Source Optical Coherence Tomography

“…Gilad et al reported that SO tamponade caused a transient decrease in the central macular thickness mainly of the inner layers. However, the thickness seemed to recover after SO removal [22,23]. This finding was supported by the finding by Danielle et al, who divided the subjects into two groups depending on the retinal thickness (thicker vs. thinner group) during SO tamponade.…”

“…Sebastian et al reported that retinal thinning induced by the mechanical pressure of SO could be a possible cause [25]. In addition, SO toxicity and dehydration were hypothesized as potential mechanisms of retinal thinning; however, this remains unproved to date [23].…”

Makula Tutulumu Olmayan Regmatojen Retina Dekolmanlı Hastalarda Silikon Yağı Kullanımının Makula Tabakalarının Kalınlıkları Üzerine Etkisi

“…Ancak bu sonuçlar genellikle anatomik anlamda tatmin edici olmaktadır 15 . Silikon yağları yıllardır kullanılmasına ve nispeten güvenli olmasına rağmen, literatürde silikon yağı kullanımından sonra görme kaybı olan vakalar bildirilmiştir [4][5][6][7]15,16 .Caramoy ve ark. göz içi tamponad olarak silikon yağı kullandıkları makula tutulumu olmayan RD olgularında GHT ve İPT kalınlık değerlerinin hastaların sağlıklı gözlerine göre belirgin ince olduğunu bildirmişlerdir 15 .…”

“…Çalışmalarda bu sonuçları açıklamak adına birkaç teori ortaya atılmıştır. Bunlardan birincisi silikon yağı tarafından retina üzerinde indüklenen mekanik basınç nedeni ile tamponadın kendisi retina incelmesine neden olabilir [5][6][7] . Bir diğer teori ise retinal toksisitedir 16 .…”

“…Bununla birlikte silikonize gözlerde başarılı bir tamponlamaya rağmen bazen görsel iyileşme, beklenilen düzeyde olmamaktadır [1][2][3] . Silikonun emülsifiye olmuş partiküllerinin retinal dokulara penetrasyonu, artmış mekanik bası ve göz içi hidrofilik ortamın silikon ile hidrofobik bir ortama dönüşmesinin retina katmanları üzerinde olumsuz etkileri olabileceği ve bunun görsel sonuçları olumsuz yönde etkileyebileceği bildirilmiştir [4][5][6][7] .…”