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Seong, Chung, Lee, Kim, and Yoon: The Clinical Results of Silicone Oil Tamponade in Pars Plana Vitrectomy for Various Vitreoretinal Diseases
Original Article

J Korean Ophthalmol Soc 2007;48(8):1057-1066.

Published online: 24 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.8.1057-1066

The Clinical Results of Silicone Oil Tamponade in Pars Plana Vitrectomy for Various Vitreoretinal Diseases

Min Cheol Seong, M.D., Hye Won Chung, M.D., Sun Young Lee, M.D., June Gone Kim, M.D., Young Hee Yoon, M.D.

Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

Address reprint requests to Young Hee Yoon, M.D., Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, #388-1 Poongnap-dong, Songpa-gu, Seoul 138-400, Korea, Tel: 82-2-3010-3680, Fax: 82-2-470-6440, E-mail: yhyoon@amc.seoul.kr

Received 3 January 2006       Accepted 22 May 2007

Copyright © 2007 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study aimed to report anatomic and visual acuity outcomes after 5000-centistoke silicone oil was used as a retinal tamponade for the treatment of various causes of vitreoretinal diseases.

Methods

Two hundred ten eyes of 196 patients who had undergone vitrectomy with silicone oil between 1995 and 2004 were reviewed retrospectively. According to etiology, the eyes were divided into five groups : (1) Group 1 included 60 eyes associated with proliferative diabetic retinopathy, (2) Group 2 included 90 eyes associated with proliferative vitreoretinopathy, (3) Grouop 3 included 30 eyes associated with trauma, (4) Group 4 included 13 eyes associated with infection or other inflammatory disease, (5) Group 5 included 17 eyes associated with submacular hemorrhage or etc. Anatomic outcomes included complete retinal attachment and macular attachment. Visual acuity outcomes included ambulatory vision (>4/200) and preservation of preoperative visual acuity.

Results

At the last examination, the retina was completely attached in 98.1% of cases in Group 1, 98.9% Group 2, 82.6% Group 3, 83.3% Group 4 and 100% Group 5. The macula was attached in 98.1%, 98.9%, 87.0%, 100%, and 100% eyes, respectively. Ambulatory vision was achieved in 28 eyes (46.7%) in Group 1, 50 eyes (55.6%) in Group 2, 9 eyes (30.5%) in Group 3, 8 eyes (61.5%) in Group 4, and 6 eyes (35.3%) in Group 5.

Conclusions

Vitrectomy with 5000-centistoke silicone oil tamponade is an effective method in the management of vitreoretinal diseases with multiple etiologies.

Keywords: Anatomic Outcomes, Silicone Oil Tamponade, Visual Acuity Outcomes

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Figure 1.
Anatomic and visual acuity outcomes at postoperative examinations for Group 1A (blue line) and Group 1B (pink line) treated with vitrectomy with silicone oil injection. (A) percent of eyes with completely attached retinas. (B) percent of eyes with attached maculae. (C) percent of eyes with preserved visual acuity. (D) percent of eyes with ambulatory visual acuity (≥ 20/1000).
jkos-48-1057f1.tif
Figure 2.
Anatomic and visual acuity outcomes at postoperative examinations for Group 2A (blue line) and Group 2B (pink line) treated with vitrectomy with silicone oil injection. (A) percent of eyes with completely attached retinas. (B) percent of eyes with attached maculae. (C) percent of eyes with preserved visual acuity. (D) percent of eyes with ambulatory visual acuity (≥ 20/1000).
jkos-48-1057f2.tif
Figure 3.
Anatomic and visual acuity outcomes at postoperative examinations for Group 3 (blue line), Group 4 (pink line) and Group 5 (yellow line) treated with vitrectomy with silicone oil injection. (A) percent of eyes with completely attached retinas. (B) percent of eyes with attached maculae. (C) percent of eyes with preserved visual acuity. (D) percent of eyes with ambulatory visual acuity (≥ 20/1000).
jkos-48-1057f3.tif
Table 1.
Preoperative characteristics of study groups
Characteristic Group 1 Group 2 Group 3 Group 4 Group 5
No. of patients 53 87 30 9 17
No. of eyes 60 90 30 13 17
  1 eye (%) 46 (86.8%) 84 (96.6%) 30 (100%) 5 (55.6%) 17 (100%)
  2 eyes (%) 7 (13.2%) 3 (3.4%) 0 (0%) 4 (44.4%) 0 (0%)
Age (yrs) * 50.63±9.94 45.22±19.65 40.53±17.20 54.69±10.63 63.12±17.69
Gender
  Male 28 (52.8%) 53 (60.9%) 26 (86.7%) 4 (44.4%) 8 (47.1%)
  Female 25 (47.2%) 34 (39.1%) 4 (13.3%) 5 (55.6%) 9 (52.9%)
Visual acuity †
  NLP‡ /LP§ 2/7 (15.0%) 1/9 (11.1%) 3/11 (46.7%) 0/3 (23.1%) 0/4 (23.5%)
  CFAΠ/HM# 16/14 (50.0%) 15/28 (47.8%) 4/11 (50.0%) 4/4 (61.5%) 0/9 (52.9%)
  0.02-0.1 17 (28.3%) 11 (12.2%) 0 (0%) 1 (7.7%) 2 (11.8%)
  0.1-1.0 4 (6.7%) 26 (28.9%) 1 (3.3%) 1 (7.7%) 2 (11.8%)
Status of lens
  Phakic 52 (86.7%) 57 (63.3%) 17 (56.7%) 9 (69.2%) 15 (88.2%)
  Pseudophakic 8 (13.3%) 23 (25.6%) 0 (0%) 3 (23.1%) 2 (11.8%)
  Aphakic 0 (0%) 10 (11.1%) 13 (43.3%) 1 (7.7%) 0 (0%)
Prior retinal surgery
  None 49 (81.7%) 61 (67.8%) 2 (6.7%) 5 (38.5%) 12 (70.6%)
  ≥1 11 (18.3%) 29 (32.2%) 28 (93.3%) 8 (61.5%) 5 (29.4%)

∗ Values are mean±standard devation.

† Snellen equivalents : a) 0.02-0.1=20/1000-20/200; b) 0.1-1.0=20/200-20/20.

‡ NLP=no light perception,

§ LP=light perception,

Π CF=counting finger,

# HM=hand motion.

Table 2.
Preoperative and postoperative best corrected visual acuity (LogMAR) : mean±standard devation
  Preoperative BCVA∗ Last follow up BCVA∗ p-value
Group 1 (60 eyes) 2.07±0.52 1.91±0.73 0.136
  Without Retinectomy (45 eyes) 2.03±0.52 1.87±0.74 0.232
  With Retinectomy (15 eyes) 2.17±0.50 2.00±0.71 0.326
  First operation (49 eyes) 2.01±0.52 1.84±0.75 0.199
  Reoperation (11 eyes) 2.32±0.43 2.19±0.57 0.172
Group 2 (90 eyes) 1.72±0.86 1.69±0.83 0.682
  Retinectomy was not done (68 eyes) 1.61±0.87 1.58±0.82 0.730
  Retinectomy was done (22 eyes) 2.07±0.74 2.04±0.78 0.825
  First operation (61 eyes) 1.65±0.87 1.71±0.83 0.589
  Reoperation (29 eyes) 1.87±0.84 1.64±0.84 0.064
Group 3 (30 eyes) 2.41±0.34 2.05±0.78 0.014†
  Retinectomy was not done (14 eyes) 2.25±0.39 1.69±0.93 0.062
  Retinectomy was done (16 eyes) 2.56±0.23 2.36±0.45 0.075
  First operation (3 eyes) 2.50±0.35 1.80±0.69 0.181
  Reoperation (27 eyes) 2.40±0.35 2.08±0.79 0.040†
Group 4 (13 eyes) 2.12±0.61 1.87±0.67 0.270
  Retinectomy was not done (9 eyes) 2.18±0.35 1.74±0.67 0.139
  Retinectomy was done (4 eyes) 1.98± 1.06 2.15±0.66 0.592
  First operation (5 eyes) 1.94±0.88 1.90±0.88 0.925
  Reoperation (8 eyes) 2.23±0.41 1.85±0.57 0.180
Group 5 (17 eyes) 2.05±0.68 2.19±0.50 0.405
  Retinectomy was not done (10 eyes) 1.81±0.81 2.05±0.60 0.399
  Retinectomy was done (7 eyes) 2.39±0.15 2.39±0.23 1.000
  First operation (12 eyes) 1.89±0.76 2.31±0.45 0.017†
  Reoperation (5 eyes) 2.42±0.16 1.90±0.55 0.124

∗ BCVA=best corrected visual acuity.

† statistically significant.

Table 3.
Anatomical and visual outcomes at 1, 4, 9 and 12 months and at the last examination : No. (%)
Outcome Exam Group 1-A Group 1-B Group 2-A Group 2-B Group 3 Group 4 Group 5
Complete attachment 1 month 38/38 (100) 15/15 (100) 59/61 (96.7) 28/29 (96.6) 22/23 (95.7) 5/6 (83.3) 4/4 (100)
4 months 37/38 (97.4) 13/15 (86.7) 59/61 (96.7) 27/29 (93.1) 20/23 (87.0) 5/6 (83.3) 3/4 (75.0)
9 months 27/27 (100) 10/12 (83.3) 38/42 (90.5) 18/20 (90.0) 16/18 (88.9) 5/6 (83.3) 3/3 (100)
12 months 23/23 (100) 7/7 (100) 27/30 (90.0) 11/13 (84.6) 12/13 (92.3) 6/6 (100) 3/3 (100)
Last visit 38/38 (100) 14/15 (93.3) 61/61 (100) 28/29 (96.6) 19/23 (82.6) 5/6 (83.3) 4/4 (100)
Macular attachment 1 month 38/38 (100) 15/15 (100) 60/61 (98.4) 28/29 (96.6) 22/23 (95.7) 6/6 (100) 4/4 (100)
4 months 37/38 (97.4) 14/15 (93.3) 60/61 (98.4) 28/29 (96.6) 21/23 (91.3) 5/6 (83.3) 3/4 (75.0)
9 months 27/27 (100) 11/12 (91.7) 39/42 (92.9) 19/20 (95.0) 17/18 (94.4) 6/6 (100) 3/3 (100)
12 months 23/23 (100) 7/7 (100) 29/30 (96.7) 12/13 (92.3) 12/13 (92.3) 6/6 (100) 3/3 (100)
Last visit 38/38 (100) 14/15 (93.3) 61/61 (100) 28/29 (96.6) 20/23 (87.0) 6/6 (100) 4/4 (100)
Preserved vision 1 month 27/45 (60.0) 10/15 (66.7) 39/61 (64.0) 21/29 (72.4) 28/30 (93.3) 12/13 (92.3) 12/17 (70.6)
4 months 28/45 (62.2) 12/15 (80.0) 38/61 (62.3) 21/29 (72.4) 29/30 (96.7) 11/13 (84.6) 11/17 (64.7)
9 months 22/33 (66.7) 9/12 (75.0) 26/42 (61.9) 16/20 (80.0) 21/24 (87.5) 10/12 (83.3) 7/11 (63.7)
12 months 18/26 (69.2) 4/7 (57.1) 19/30 (63.3) 11/13 (84.6) 14/17 (82.4) 6/9 (66.7) 4/5 (80.0)
Last visit 29/45 (64.4) 10/15 (67.7) 36/61 (59.0) 21/29 (72.4) 25/30 (83.3) 8/13 (61.5) 10/17 (58.8)
Ambulatory vision 1 month 16/45 (35.6) 5/15 (33.3) 32/61 (52.5) 12/29 (41.4) 6/30 (20.0) 4/13 (30.8) 2/17 (11.8)
4 months 20/45 (44.4) 4/15 (26.7) 34/61 (55.7) 18/29 (62.1) 9/30 (30.0) 7/13 (53.8) 4/17 (23.5)
9 months 14/32 (42.4) 5/12 (41.7) 24/42 (57.1) 13/20 (65.0) 8/24 (33.3) 7/12 (58.3) 2/11 (18.2)
12 months 16/26 (61.5) 2/7 (28.6) 13/30 (43.3) 9/13 (69.2) 7/17 (41.2) 5/9 (55.6) 2/5 (40.0)
Last visit 24/45 (53.3) 4/15 (26.7) 33/61(54.1) 17/29(58.6) 9/30(30.0) 8/13(61.5) 6/17 (35.3)
Table 4.
Complication after pars plana vitrectomy and silicone oil injection : Number of eyes
  Group 1A Group 1B Group 2A Group 2B Group 3 Group 4 Group 5
  (45 eyes) (15 eyes) (61 eyes) (29 eyes) (30 eyes) (13 eyes) (17 eyes)
IIOP∗ 24 5 36 11 8 2 9
NVG† /IIOP∗ eyes 5/24 0/5 0/36 1/1 1 0/8 0/2 1 /9
Cataract/Phakic eyes 19/27 0/2 12/22 1/4 0/2 2/2 5/9
RD‡ 1 3 7 3 3 3 0
ERM§ 0 0 2 2 1 0 1
Emulsification 0 0 8 2 0 0 0
Corneal opacity 0 1 0 0 3 1 1
Endophthalmitis 1 0 1 0 0 0 0
Band keratopathy 0 0 1 1 2 1 1
Others PCOΠ (1) Phthisis (1) Hyphema (1) Hyphema (1) Phthisis (2)    
      Retinal fold (1) Symblepharon (1)      
      Silicone oil in Submacular      
      AC#(2) hemorrhage (1)      

∗ IIOP=increased intraocular pressure,

† NVG=neovascular glaucoma,

‡ RD=retinal detachment,

§ ERM=epiretinal membrane,

Π PCO=posterior capsular opacification,

# AC=anterior chamber.

Table 5.
Effect of silicone oil removal
  Group 1A Group 1B Group 2A Group 2B Group 3 Group 4 Group 5
  (45 eyes) (15 eyes) (61 eyes) (29 eyes) (30 eyes) (13 eyes) (17 eyes)
No. of removal 30 (66.7%) 1 (6.7%) 38 (62.3%) 15 (51.7%) 17 (56.7%) 5 (38.5%) 7 (41.2%)
Time of SO∗ removal (months)† 10.07±6.21 7 27.28±21.27 28.97±24.38 10.41±7.68 18.40±13.07 8.29±6.55
Retina redetached 3 (10.0%) 0 (0%) 6 (15.8%) 1 (6.7%) 5 (29.4%) 1 (20%) 2 (28.6%)
Time of redetachment (months)† 0.68±0.56   5.37±10.15 2 3.70±3.46 0.5 2.00±1.41

∗ SO=silicone oil.

† Values are mean±standard devation.

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