Long-term Results of Pars Plana Vitrectomy and Silicone Oil for Complications of Diabetic Retinopathy

Abstract

Pars plana vitrectomy (PPV) with silicone oil implantation (SOI) was performed for advanced proliferative diabetic retinopathy (PDR) in 110 eyes of 98 diabetic patients. In 77 eyes (70%) it was a primary SOI as part of the initial operation; in 33 eyes (30%) it was a secondary SOI in reoperations. Indications for SOI were traction retinal detachment of the posterior pole, combined traction and rhegmatogenous detachment, vitreous haemorrhage with florid vascularised fibrous proliferations, and recurrent vitreous haemorrhage after PPV. The patients were followed up for 24 to 72 months, with a mean of 53 months. At the end of follow-up, anatomical success was achieved in 63 eyes (57%), and functional success with visual acuity 0.01 and better in 35 eyes (32%). Functional failures were caused by retinal redetachment in 47 eyes (43%), by secondary glaucoma in 10 eyes (9%), retinal ischemia in 15 eyes (13%) and keratopathy in three eyes (3%). The functional success rate decreased with follow-up from 67% after six months to 50% by 60 months after SOI. Silicone oil bubble in the anterior chamber, rubeosis iridis, cataract, and glaucoma were the most frequent postoperative complications. PPV with SOI was highly effective in many serious complications of advanced PDR. Functional success was mostly lasting and markedly improved the quality of life of these patients.

Mechanical Blepharoptosis and Eyelid Swelling Caused by Silicone Oil

“…In general, silicone oil removal should be attempted after 3 months to prevent the formation of secondary glaucoma or of cataract. 2 Intraocular silicone oil can migrate into the subconjunctival space and orbit through an Ahmed glaucoma valve. 3 Migration of silicone oil into the upper eyelid from the vitreous cavity after traumatic retinal detachment surgery is very rare and few cases have been described in the literature.…”

Retrospective review of 50 eyes with long-term silicone oil tamponade for more than 12 months

“…They are usually reserved for complex cases of retinal detachments [2] and proliferative diabetic retinopathy associated with tractional retinal detachment [3,4]. These agents are also primarily injected in eyes with severe trauma to stabilize the retina and inhibit the proliferative activity period that follows such complex cases [5].…”

Front Matter

“…5). Evidence of improving visual results during the last 20 years following vitrectomy has been shown in studies reported by Blankenship, 60 Thompson,[61][62][63][64] Sigurdsson, 65 Flynn, 66 Nakazawa 67 , Karel, 68 Harbour, Pendergast, 70 La Heij, 71 Yamamoto, 72 Amino, 73 Lewis, 74 Lahey, 75 Treumer, 76 Schrey, 77 and Diolaiuti. 78 However, a restriction in driving field has recently been reported in over two-thirds of patients in a small series of patients by Barsam 79 .…”