Characteristics, fates and complications of long-term silicone oil tamponade after pars plana vitrectomy

Abstract

Background: Silicone oil tamponade has become a mainstay in treatment of advanced retinal detachment due to multiple etiologies. The aim of this study is to assess the characteristics, fates and complications of long-term silicone oil tamponade after par plana vitrectomy (PPV), and to compare the outcomes of different silicone oil viscosities used in a cohort of consecutive patients. Methods: This is a retrospective comparative case series of eyes undergoing vitrectomy with silicone oil tamponade for retinal detachment by a single surgeon using different oil viscosities that were followed for one year with the silicone oil in situ. Visual acuity (VA), intraocular pressure (IOP) and complications associated with the follow up period were analyzed and compared. Results: Eighty-five eyes of 85 patients were included in this study. Forty three patients had 1000 centistoke (cs) oil injected and 42 patients had 5000cs oil utilized. Demographic, cause of retinal detachment and preoperative ocular characteristics were similar in both groups. Long term complications in both groups included ocular hypertension (67.4% vs 66.7%), keratopathy due to silicone oil emulsification and migration to the anterior chamber (7.0% vs 11.9%), recurrent retinal detachment (4.7% vs 19%) and epiretinal membrane formation (7% vs 19%). In the 1000cs oil group, there was no significant difference between baseline IOP and any subsequent visit. There was a significant difference between baseline IOP and visits at day 1 (with IOP difference of 2.61 mmHg (±6.5)) (p = 0.028), 1 month (with IOP difference of 3.52 mmHg (±8.1)) (p = 0.026), 4 months (with IOP difference of 6.38 mmHg (±9.3)) (p = 0.005), and one year (with IOP difference of 4.24 mmHg (±11.1)) (p = 0.048), all higher in the post-operative period in the 5000cs oil group. Excluding the first post-operative day, no significant difference was found for VA between baseline visits and subsequent visits for either silicone oil groups.

Complications associated with the use of silicone oil in vitreoretinal surgery: A systemic review and meta‐analysis

“…Although lower mean interval time between PPV and cataract surgery has been reported in eyes filled with SO (Abu‐Yaghi et al. 2020), there were not enough data in the included studies to verify it, so it could be interesting to carry out future studies being rigorous in data collection.…”

“…2017; Abu‐Yaghi et al. 2020) have been known for quite time, SO remains one of the favourites agents for long‐standing vitreous replacement (Saleh et al. 2020).…”

“…2019; Abu‐Yaghi et al. 2020). Silicone oil (SO) is strongly lipophilic, and it is capable of dissolving the lipids of the cell membranes inside the eye, with which its long‐term toxicity seems out of the question (Pastor Jimeno et al.…”

“…2019; Abu‐Yaghi et al. 2020). However, in certain cases, ROSO is also associated with complications including recurrent RD and hypotony (Issa et al.…”

“…2017; Abu‐Yaghi et al. 2020), and also, with the possibility of having the so named silicone retinotoxicity with reported cases of central visual loss, decreased choroidal thickness, subretinal and even intracranial migration (Toklu et al. 2012; Miller et al.…”