Results and complications of temporary silicone oil tamponade in patients with complicated retinal detachments

Abstract

Background: To assess the results and complications of temporary silicone oil tamponade in the treatment of complicated retinal detachments.

Methods: Fifty-eight consecutive eyes undergoing silicone oil removal were studied in a retrospective fashion. Forty-two eyes with proliferative vitreoretinopathy, nine eyes with giant tears, and seven traumatized eyes were included. In addition to anatomic and visual results, the following complications and their associated preoperative and intraoperative variables were assessed: glaucoma, hypotony, and keratopathy.

Results: Anatomic success was achieved in 81% of the eyes. Postoperative glaucoma was found in 12%, hypotony in 9%, and keratopathy in 7% of the eyes. Twenty-six (45%) of the 58 eyes had an increase in visual acuity of at least two Snellen lines after silicone oil removal. After multivariate logistic regression analysis for all variables versus the visual and anatomic results and versus the complications of glaucoma, hypotony, and keratopathy successively, a total of three or more operations (P < 0.05; odds ratio, 14.7) and the absence of an encircling band (P < 0.05; odds ratio, 29.9) were associated with redetachment, and a retinectomy size of more than 180 degrees was associated with hypotonia (P < 0.05; odds ratio, 67.5).

Conclusions: Temporary silicone oil tamponade may be associated with a lower incidence of complications than recent studies have reported. Despite the acceptable risk of recurrent retinal detachment, the early removal of silicone oil may yield a lower rate of anterior segment complications and an increase in visual acuity in approximately half the eyes.