Silicone oil (SO), used in complicated retinal detachments, is associated with complications such as cataract, increased intraocular pressure (IOP), keratopathy, cystoid macular oedema (CMO), epiretinal membrane (ERM) and loss of vision. Emulsification of oil can also lead to migration of oil droplets into the retinal pigment epithelium (RPE) and optic nerve. Removal of SO is recommended about three to six months after the initial treatment to minimise these complications. The authors looked at 75 eyes in 73 patients in which SO tamponade was used in primary retinal detachment (primRD, 35 eyes) or recurrent detachment (recRD, 40 eyes). Before SO removal (SOR), more eyes were found to have CMO in the recRD group compared to primRD. There was no significant difference between ERM or macular hole in these groups. Before SOR, ellipsoid zone (EZ) disruption was found in both groups in more than half the eyes in both groups. There was also significantly thinner nerve fibre layer in the eye with SO in situ compared to the fellow untreated eye. There was no significant difference for each group in best corrected visual acuity (BCVA) during the postoperative follow-up. Significantly worse VA was observed in patients with EZ disruption at last follow-up visit. Eleven percent developed a re-detachment following SOR. Two eyes lost vision after SOR in which duration of SO was five and seven months respectively. Visual acuity was 0.05 logMAR pre-op and dropped to 1.0 immediately after SOR. Both eyes had thinning of central retina on OCT. The authors confirm a correlation between duration of SO tamponade and worse visual function, and this is associated with EZ integrity on OCT, and was not related to underlying disease, whether it was primary or recurrent retinal detachment.
Silicone oil in rhegmatogenous retinal detachment
Reviewed by Kurt Spiteri Cornish
Silicone oil tamponade in rhegmatogenous retinal detachment: functional and morphological results.
CONTRIBUTOR
Kurt Spiteri Cornish
Sheffield Teaching Hospitals NHS Trust, London, UK.
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