Removal of Silicone Oil

Abstract

The incidence of retinal redetachment after ROSO in our study was 3.46%. Aggressive removal of the vitreous base, performing retinotomies, ensuring complete silicone oil filling for adequate tamponade, and argon retinopexy can lead to low complication rates and improved outcomes.

Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy

“…Choudhary et al [13] have a correspondingly low-complication rate of just under 4% in the retrospective analysis of their pars plana vitrectomies with silicone oil tamponade for the management of so-called complicated retinal detachments.…”

“…In advanced P(D)VR, the need for retinotomies and retinectomies in the outermost periphery is very likely [13, 67]. Where tractions prevent retinal reattachment, the removal of tissue (including retinal tissue) is inevitable in many cases.…”

“…Argon laser coagulation is also one of those obviously necessary parameters which should have a positive effect on the outcome. In the study by Choudhary et al [13], this is achieved in all cases as a 360° laser coagulation. However, one question remains unanswered: What stage of P(D)VR did the authors have to deal with?…”

“…21% P(D)VR versus 79% PVR are similar to our ratios of 14.6% P(D)VR versus 85.4% PVR. The best visual acuity [13] was 0.2 or higher in 50% of all eyes 3 months after oil removal; in our study, there was no patient completely blind (no light perception); 4 months after oil removal, 10% of patients had a visual acuity between light perception, and 1/50 and a quarter of the patients (26.2%) had visual acuity between 1/50 and 0.1, one third of the patients (34.9%) between 0.1 and 0.3, 17.5% developed vision 0.3 to ≤0.5, and 10.7% saw better than 0.5; in more than a quarter of our patients, no visual aids were needed for reading (visual acuity of at least 0.3).…”

“…The cause analysis is “poor” and not sufficient to draw clear-cut conclusions to improve the success rate [1–13]. This poses the question, which parameters should be sought differently and improved upon in order to systematically reduce the rate of redetachments of the retina after the removal of silicone oil and to also check to what extent this is possible.…”