Combined removal of silicone oil plus internal search (ROSO-plus) following retinal detachment surgery

Abstract

Purpose: To report the rate of retinal redetachment and intervention with combined removal of silicone oil plus internal search (ROSO-plus) and to report the pathology identified.

Methods: Preoperative and peroperative findings were related to postoperative failure of the surgery defined as retinal redetachment postoperatively or silicone oil in situ at the final follow-up.

Results: Sixty-three patients were included in the study. Mean follow-up was 13 months. Retinopexy and further tamponade were used in 22 patients. Overall 'ROSO-plus' failed in 13 (21%) patients. Patients with subretinal fluid (SRF) in the inferior quadrants of the fundus during 'ROSO-plus' were particularly at risk of failure at 86% (six of seven patients) vs 12.5% (7/56) for the remainder (P=0.0002, relative risk=6.9, 95% confidence interval 3.2-14.6). The overall success rate at final follow-up (after any further surgery) for a flat retina without oil in situ was 83%.

Conclusion: The 'ROSO-plus' procedure allowed identification of problems expected to result in anatomical failure. Treatment did not prevent a high rate of postoperative retinal detachment. Refinement of the treatment algorithm is required with perhaps more use of silicone oil reinsertion in high-risk eyes.