The incidence of unexplained visual loss following removal of silicone oil

Moya, Rene; Chandra, Aman; Banerjee, Pratik; Tsouris, Dimitros; Ahmad, Nadeem; Charteris, David G.

doi:10.1038/eye.2015.135

Cited by 64 publications

(90 citation statements)

References 23 publications

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“…In this study, we analyzed 554 consecutive SO removal operations over 2 years at 1 tertiary referral vitreoretinal center (Magrabi Eye Hospital, Tanta, Egypt) and found 12 cases of unexplained visual loss. This suggests an overall incidence of 2.2% of unexplained visual loss, which is close to the results of Moya et al [10] , who reported a 3.3% overall incidence of visual loss following SO removal, while Herbert et al [11] documented that the condition has been estimated to occur in up to 10% of SO-filled eyes.…”

Section: Discussionsupporting

confidence: 77%

“…Herbert et al [11] reported that 5 patients had developed central visual loss with SO in situ in a retrospective study; the oil was in place for an average of 2.7 months when the scotomas arose, and were associated with decreased visual acuity and visual field defects. In contrast, Moya et al [10] reported 14 patients with reduction of visual acuity after SO removal.…”

Section: Color Version Available Onlinementioning

confidence: 95%

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Silicone Oil-Related Visual Loss

et al. 2017

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Background: Silicone oil (SO) is used as an intravitreal tamponade agent in vitreoretinal surgery for rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy or with large, multiple retinal tears. Usually, SO is left in the eye for at least 3 months. Although its use can lead to well-known complications, intraocular SO is generally well tolerated. Some studies have reported unexpected central vision loss after SO use or removal. Objective: To investigate and analyze the reason for visual loss after the use or removal of intraocular SO in patients who underwent vitrectomy surgeries for RRD. Patients and Methods: A retrospective observational case series of 12 patients with macula-on RRD who reported visual loss after the use or removal of SO was reviewed. Investigations carried out included fundus fluorescein angiography, optical coherence tomography (OCT) of the macula and optic disc, perimetry, and electrophysiological study. Electrolyte levels were measured in retro-oil fluid and compared with their levels in the vitreous humor of patients who underwent vitrectomy for macular holes, floaters, dropped intraocular lenses, or dropped crystalline lens fragments. Results: Visual acuity levels dropped by at least 2 Snellen chart lines. None of the 12 cases had macular detachment at any stage. Fundus fluorescein angiography and OCT results were unremarkable in most of the cases. Mean levels of electrolytes in retro-oil fluids and vitreous humor were similar. Conclusion: Visual loss is a possible complication after SO use or removal. This still remains a mysterious issue which needs further research and investigation.

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Section: Discussionsupporting

confidence: 77%

Section: Color Version Available Onlinementioning

confidence: 95%

Silicone Oil-Related Visual Loss

et al. 2017

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“…The mechanism of how SO endotamponade causes retinal thinning remains unclear. Previous studies have shown the migration of SO into the ocular tissues, including the optic nerve, and the subsequent induction of an inflammatory response mediated by macrophages in several human and animal studies [12][13][14][15][29][30][31][32] ; however, retinal thinning occurs not only in severe cases but also in mildto-moderate cases; thus, it is difficult to conclude that SO intraretinal infiltration is the only cause for the retinal thinning. There have also been reports on the changes in visual outcome and retinal thickness caused by treatment with SO endotamponade.…”

Section: Discussionmentioning

confidence: 86%

“…SO is used with expectancy for intraocular tamponade and retinal reconstruction to prevent recurrence. Nevertheless, various complications, such as cataract, glaucoma, and corneal diseases, have been reportedly involved in the use of SO [11][12][13] . Among them, visual loss presumably caused by the SO endotamponade treatment, without an apparent reason, has been reported [14][15][16] .…”

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confidence: 99%

Increased Retinal Thinning after Combination of Internal Limiting Membrane Peeling and Silicone Oil Endotamponade in Proliferative Diabetic Retinopathy

Kaneko

Matsuura²,

Takayama³

et al. 2017

Ophthalmologica

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Background: The aim of this study was to examine the change in retinal thickness after vitrectomy with internal limiting membrane (ILM) peeling and/or silicone oil (SO) endotamponade in proliferative diabetic retinopathy (PDR). Methods: The actual amount and ratio of changes in the retinal thickness were calculated. Results: Compared to control eyes in the ILM peeling (-)/SO (-) group, the central, superior inner, and temporal inner retina in the ILM peeling (+)/SO (-) group, the central and superior inner retina in the ILM peeling (-)/SO (+) group, and the central, inferior inner, temporal inner, and nasal inner retina in the ILM peeling (+)/SO (+) group showed a significant reduction of the retinal thickness. The central, superior inner, and temporal inner retina in the ILM peeling (+)/SO (-) group, the central and superior inner retina in the ILM peeling (-)/SO (+) group, and the central, superior inner, inferior inner, and temporal inner retina in the ILM peeling (+)/SO (+) group showed a significantly increased reduction rate of the retinal thickness compared to the control group. Conclusions: Macular retinal thinning in PDR was observed after ILM peeling and SO endotamponade, and it was increased by the combination of these 2 factors.

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“…No influence of the tamponade on the occurrence of re-detachment was found. This suggests that in our practice, the focus has to be put on further reduction of SO tamponade in future cases to reduce possible complications and the need of a second procedure (SO removal) [29] .…”

Section: Discussionmentioning

confidence: 99%

Primary Retinal Detachment Surgery: Changes in Treatment and Outcome in an Austrian Tertiary Eye Center

Smretschnig¹,

Falkner-Radler²,

Spörl³

et al. 2017

Ophthalmologica

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Purpose: The surgery of choice for primary retinal detachment (RD) has shifted towards primary vitrectomy (PPV) in recent years. In this study, 2 cohorts of consecutive patients, treated by 8 retinal surgeons within a 7-year time span were compared. Methods: Baseline demographic data, surgical procedure, and outcome of patients with primary RD surgery between January 2007 and December 2008 (group 1, G1) and January 2012 and December 2013 (group 2, G2) were compared. Statistical analysis included univariate comparisons (Wilcoxon rank-sum test and χ² test) and ANCOVA (analysis of covariance) models. Results: The most common primary procedure was scleral buckling (n = 92, 66%) in G1 and PPV (n = 252, 85%) in G2 (p < 0.0001). Primary anatomical success rates were comparable (89%). The percentage of eyes with best corrected visual acuity (BCVA) equal or better than 0.3 logMAR (6/12) at final follow-up was significantly higher in G2 (61%, n = 156) compared to 49% (n = 68) in G1 (p = 0.0223). Conclusions: Within 7 years, a complete trend reversal could be observed shifting the primary surgical approach for RD towards PPV. Primary and final anatomical success rates were comparable, yet the later group experienced a significantly higher gain in BCVA, which approves the change in treatment regimen.

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The incidence of unexplained visual loss following removal of silicone oil

Cited by 64 publications

References 23 publications

Silicone Oil-Related Visual Loss

Silicone Oil-Related Visual Loss

Increased Retinal Thinning after Combination of Internal Limiting Membrane Peeling and Silicone Oil Endotamponade in Proliferative Diabetic Retinopathy

Primary Retinal Detachment Surgery: Changes in Treatment and Outcome in an Austrian Tertiary Eye Center

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