Silicone oil removal after rhegmatogenous retinal detachment: comparing techniques

Abstract

Purpose To assess the outcome of silicone oil removal after rhegmatogenous retinal detachment (RRD) surgery, and to compare results of a two-port (infusion-extraction) versus a three-port (full vitrectomy) approach. Methods Primary outcome measure was the rate of redetachment. Secondary outcome measures were visual acuity, rate of intraoperative and postoperative epiretinal membrane removal and complications. Results We included 147 consecutive cases. There were 15 cases of giant retinal tear, 26 cases of RRD without proliferative vitreoretinopathy (PVR) and 106 cases of RRD with PVR. The overall redetachment rate after silicone oil removal was 17.7%. In the group treated with the two-port technique (n ¼ 95), the retina redetached in 16 cases (16.8%), and in the group treated with the three-port technique (n ¼ 52), redetachment occurred in 10 cases (19.2%). This difference was not statistically significant (P ¼ 0.717; v 2 -test). There was a significantly higher redetachment rate in cases with a short oil tamponade duration of o2 months. Conclusion We reconfirm a relatively high redetachment rate after silicone oil removal. The risk of redetachment is not lower with the threeport compared with the two-port approach.

Timing and outcomes after silicone oil removal in proliferative vitreoretinopathy: a retrospective clinical series

“…In this study, the relation between duration of silicone oil tamponade and incidence of retinal redetachment was not established. In the literature, while some authors did not consider the timing of silicone oil removal as a risk factor for anatomic success rate [4,8,9], others observed that shorter tamponade duration had lower attachment rate than longer tamponade duration [10,11]. …”

Response to Wong et al.

“…More often than not, the patients with fungal endophthalmitis may have only minor discomfort. [2][3][4] Similarly, not all clinicians agree with the routine use of intravitreal antibiotics in prophylaxis. 5 In patients with open globe injuries and traumatic endophthalmitis, there is always a risk of associated retinal detachment or choroidal detachment.…”

“…Before instituting antifungal treatment, distinguishing fungal from bacterial post-traumatic endophthalmitis is important because the treatments are different and prophylactic antifungal treatment can be toxic both systemically or locally. [2][3][4] A clinical feature that suggests fungal infection is a delayed onset of inflammation after injury. [2][3][4] Literature search has reported that all post-traumatic cases of fungal endophthalmitis became symptomatic between the first and fifth weeks after injury, with minimal discomfort to the patient.…”

“…[2][3][4] A clinical feature that suggests fungal infection is a delayed onset of inflammation after injury. [2][3][4] Literature search has reported that all post-traumatic cases of fungal endophthalmitis became symptomatic between the first and fifth weeks after injury, with minimal discomfort to the patient. 3,4 In the absence of microbiological diagnosis, clinical signs suggesting infection include slow indolent smouldering intraocular inflammation associated with a relatively quiet eye, which may or may not be associated with the presence of an inflammatory mass in the vitreous or anterior chamber that is described as a 'fungal ball', or white vitreous 'snowball', or 'string of pearls'.…”

“…2 Dr Wong et al state that the number of cases with less than 2 months of tamponade is disproportionally low. The reason for the unequal distribution is that we consider 3 months as the minimum period of tamponade.…”