[Treatment of vitreoretinal proliferation in rhegmatogenous detachment and silicone oil tamponade]

Abstract

Purpose: To describe our technique of vitrectomy and silicone oil tamponade for managing retinal detachment and to report the last results according to the posterior and anterior proliferative vitreoretinopathy.

Methods: A retrospective study was conducted in 108 patients who underwent vitreoretinal surgery and silicone oil tamponade for proliferative vitreo-retinopathy, 64% patients had already been operated without success and 42% underwent vitrectomy with SF6 or C3F8. Diffuse posterior proliferative vitreo-retinopathy (grade C3-D) was present in 64% patients and anterior proliferative vitreoretinopathy was present in 43.5%. Silicone oil was removed in 79% patients after a mean duration of 6.3 months. It was replaced by 16% C3F8. All patients were followed for a minimum of 6 months.

Results: Before silicone oil removal, 55% of the retinas were reattached posterior to the scleral buckle with one operation, 78% after 2 operations and 88% after 3 or 4 operations. An average of 2.1 vitrectomy surgeries were performed. Reproliferation was correlated with the anterior proliferative vitreo-retinopathy (p < 0.001), posterior proliferative vitreo-retinopathy (p < 0.01) or previous vitrectomy (p < 0.05). The final visual acuity was 1/20 or better in 61% of the eyes and 2/10 or better in 30.5%. After silicone oil removal, 8% retinas redetached, 21% of the eyes had hypertony, 7.5% had hypotony and 7% of the corneas had dystrophy.

Conclusion: Silicone oil tamponade was effective for the treatment of retinal detachments with proliferative vitreo-retinopathy. Since the main complications were hypertony and corneal dystrophy, silicone oil should be reserved for severe proliferative vitreo-retinopathy cases.