P 784Retinal re-detachment and visual outcome after removal of intraocular silicone oil tamponade
J. B. Jonas, H. L. J. Knorr, R. M. Rank
Purpose: To evaluate frequency and risk factors of retinal re-detachment and visual outcome after removal of intraocular silicone oil tamponade.
Patients and Methods: The study included 225 patients who consecutively underwent intraocular silicone oil removal after pars plana vitrectomy had been performed by one of two surgeons 10.15 ± 10.44 months earlier. Reasons for pars plana vitrectomy had been retinal detachment with proliferative vitreoretinopathy (n=185), and proliferative diabetic retinopathy with retinal traction detachment (n=40). Mean follow-up time was 17.37 ± 14.40 months (range, 3.02 to 67.42 months).
Results: In 57 (57/225 = 25.3%) patients, the retina detached after removal of silicone oil. Risk factors for retinal re-detachment were number of previously unsuccesful retinal detachment surgeries prior to the pars plana vitrectomy (P=0.0008); surgeon (P=0.007); visual acuity before silicone oil removal (P=0.009); incomplete removal of vitreous base (P=0.01); absence of an encircling band in eyes with proliferative vitreoretinopathy and in which an inferior retinotomy had not been performed (P=0.01); and reason for pars plana vitrectomy, with diabetic proliferative retinopathy having a better (P<0.05) prognosis than proliferative vitreoretinopathy.
Conclusion: Retinal re-detachment after removal of silicone oil endotamponade can occur in some 20% to 30% of patients depending on the criteria for use and removal of silicone oil. Risk factors of re-detachment are number of previously unsuccessful retinal detachment surgeries, surgeon, preoperative visual acuity, incomplete removal of the vitreous base, absence of an encircling band in patients with proliferative vitreoretinopathy and without inferior retinotomy, and reason for pars plana vitrectomy. Rate of retinal re-detachment is independent of the technique of silicone oil removal and duration of silicone oil endotamponade with a minimal duration of silicone oil tamponade of one month in the present study.
Department of Ophthalmology, University Erlangen-Nürnberg, D-91054 Erlangen, FRG