Outcome of Complex Retinal Detachment Surgery after Silicone Oil Removal

Abstract

The residual vitreoretinal traction especially at the vitreous base is the most likely reason for retinal redetachment after silicone oil removal, which is most commonly seen during the first 10 days.

Retinal detachment after silicone oil removal is prevented by 360 laser treatment

“…The incidence is widely variable: most studies have reported an incidence of 20–25%,1 6 8 9 11 some 15–20%,4 10 and a few below 10% 2 5 13. Several mechanisms have been advocated for redetachment: reopening of pre-existing breaks, posterior migration of an occult RD or new retinal break formation,6 and residual vitreoretinal traction at the vitreous base 13. To reduce the incidence of RD, application of an encircling band or laser treatment of different extent (ranging from panphotocoagulation to treatment from the equator to the ora serrata, to 360° laser in three or four rows) has been used.…”

“…SO removal is followed by a redetachment in up to 30% of eyes,1 – 14 with the incidence being influenced by many factors, including the type of RD, the number of previous retinal surgeries and also the surgeon 9. RD occurs usually in the first 3 months:15 16 the proposed mechanisms include reopening of pre-existing breaks, posterior migration of an occult RD, formation of new retinal breaks6 and vitreoretinal traction at the vitreous base 13…”

How effective is macula-off retinal detachment surgery. Might good outcome be predicted?

“…Others have found that 20% of these will have a recurrence of retinal detachment. [7][8][9] Other relevant studies with the exception of that of Sullivan et al 1 relate to buckling surgery from the early 1980s and conventional surgery was used in 101 of 153 (66%) of Sullivan's patients. In our study conventional surgery was used in only 30%.…”

Intraoperative Endolaser Retinopexy Around the Sclerotomy Site for Prevention of Retinal Detachment After Pars Plana Vitrectomy

“…The mechanisms of pars plana sclerotomy-related RD involve the intraoperative formation of new retinal breaks 3 and vitreoretinal traction of the vitreous base. 4 Prevalence rates of postvitrectomy RD have been reported from 1.7% to 11%, 5-10 and scleral buckling, 11 panretinal photocoagulation, 12,13 and 360°laser retinopexy [14][15][16] are procedures to prevent it. However, scleral buckling can induce complications, such as eyeball perforation, eyeball disfigurement, myopia, and intraocular pressure elevation, and panretinal photocoagulation can induce complications, such as macular edema, visual acuity decrease, visual field constriction, and choroidal hemorrhage.…”