Incidence and Risk Factors of Cystoid Macular Edema after Vitrectomy with Silicone Oil Tamponade for Retinal Detachment

Abstract

Purpose: To investigate the incidence and risk factors of cystoid macular edema (CME) after silicone oil (SO) injection for retinal detachment.

Methods: Fifty-eight patients with retinal detachment treated by vitrectomy with SO tamponade during 2011 to 2015 were retrospectively assigned to CME and non-CME groups. Patients underwent complete ophthalmological examination, including color fundus photography and preoperative and postoperative optical coherence tomography. Risk factors for CME during SO tamponade were determined by regression analyses.

Results: Of the 58 eyes, 21 (36.2%) exhibited CME. The presence of posterior staphyloma in the CME group was significantly more frequent than in the non-CME group (p = 0.026). There were no significant differences in other demographic or clinical characteristics between the CME and non-CME groups. Significant correlations were observed between CME after vitrectomy with SO tamponade and the presence of posterior staphyloma (odds ratio, 4.03; p = 0.031). Of the 21 eyes with CME, 13 underwent SO removal, among which 11 experienced resolution of CME with or without further intervention.

Conclusions: The presence of posterior staphyloma is significantly associated with CME after vitrectomy with SO tamponade. Patients with retinal detachment exhibiting posterior staphyloma should be evaluated for potential CME during SO tamponade.

Keywords: Macular edema; Retinal detachment; Silicone oil.

Fig. 1. Rhegmatogenous retinal detachment due to retinal hole in the left eye of a 75-year-old female patient. The patient had no history of hypertension or diabetes mellitus and had received cataract surgery in both eyes. Preoperative visual acuity and intraocular pressure were 0.02 Snellen units and 13 mmHg, respectively. The patient received combined vitrectomy with scleral encircling and additional laser treatment. Cystoid macular edema was detected on spectral-domain optical coherence tomography images acquired 237 days after surgery. (A) Oil removal and posterior subtenon triamcinolone injection were performed 251 days after silicone oil injection. (B) Remission of cystoid macular edema was observed on spectral-domain optical coherence tomography images acquired 1 month later.

Fig. 2. Rhegmatogenous retinal detachment due to retinal hole in the left eye of a 23-year-old female patient. The patient had no history of hypertension or diabetes mellitus. Preoperative visual acuity and intraocular pressure were 0.05 Snellen units and 23 mmHg, respectively. The patient received combined vitrectomy with scleral encircling and additional laser treatment. Cystoid macular edema was detected on spectral-domain optical coherence tomography images acquired 218 days after surgery. (A) Oil removal was performed 343 days after silicone oil injection. (B) However, remaining cystoid macular edema was observed on spectral-domain optical coherence tomography images acquired 293 days after oil removal.