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Abstract
Purpose
To evaluate clinical analyses & risk factors for retinal detachment after silicone oil removal in the eyes with completely stable retinal state.
Method
The authors retrospectively analyzed the clinical diagnosis, timing of retinal detachment, operative record, and final anatomic success of 10 consecutive eyes with retinal detachment after silicone oil removal.
Results
The retinal detachment group after silicone oil removal consisted of 3 eyes with proliferative vitreoretinopathy, 3 eyes with proliferative diabetic retinopathy, 3 eyes with the retinal detachment with macular hole and 1 eye with traumatic rhegmatogenous retinal detachment. Retinal detachment occurred from 1 to 17 weeks after the silicon oil removal surgery. The retinal detachments were associated with reopening of old breaks (5 eyes), new retinal breaks (3 eyes), vitreoretinal tractions (2 eyes). The retina was completely or partially reaatached after additional vitreoretinal surgery in 9 eyes, but total retinal detachment occurred in 1 eye due to reattachment operation rejection.
Conclusions
The retinal break with remained vitreous traction and the proliferative membrane appeared to be an important factor in retinal detachments after silicone oil removal. Therefore, potential retinal breaks and complete removal of vitreous and tractional force during intraocular surgery should be considered.
References
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Table 1.
Patient characteristics at the time of intraocular silicone oil injection
| Case | Age/Sex/Eye | Initial diagnosis | Lens status | Axial length | Combined procedure |
|---|---|---|---|---|---|
| 1 | 43/M/OD | PVR | phakia | 23.27 mm | Buckling*, MP†, PPL‡ |
| 2 | 56/M/OS | PVR | phakia | 23.27 mm | Buckling, PPV, PPL |
| 3 | 75/F/OD | PVR | pseudophakia | 21.44 mm | PPV, MP, EL§ |
| 4 | 59/F/OS | Advanced PDR | phakia | 21.84 mm | PPV. MP, EL, ECCE |
| 5 | 41/M/OD | Advanced PDR | phakia | 22.72 mm | PPV, MP, EL |
| 6 | 70/M/OS | Advanced PDR | phakia | 22.90 mm | PPV, MP, EL |
| 7 | 53/F/OS | Macular hole RD | aphakia | 31.51 mm | Add PPV |
| 8 | 65/M/OD | Macular hole RD | phakia | 21.75 mm | MP, EL, PPL |
| | | ARMD | | | |
| 9 | 60/F/OS | Macular hole RD | aphakia | 31.51 mm | MP, EL |
| 10 | 68/M/OS | Traumatic RRD | phakia | 26.27 mm | EL, Retinectomy |
Table 2.
Operation at the time of intraocular silicone oil removal and retinal detachment reoperation
| Case | Oil tamponade period | Combined procedure at oil removal | Period between RD and oil removal | RD reoperation | Final Anatomic success |
|---|---|---|---|---|---|
| 1 | 13 weeks | MP*, IV C3 F8†, 2′ IOL‡ | 6 weeks S | Soil, EL§, Retinectomy | Complete success |
| 2 | 9 weeks | MP, EL, IV C3 F8, 2′ IOL | 4 weeks | Soil, MP, EL, | Partially success |
| | | | | Removal of IOL | |
| 3 | 11 weeks | MP, IV SF6Π | 8 weeks | Refusal | Total RD |
| 4 | 16 weeks | MP, EL | 4 weeks | Additional laser | Partiallysuccess |
| | | | | photocoagulation | |
| 5 | 16 weeks | MP, EL, IV SF6 | 10 days | Soil, MP, EL | Partially success |
| 6 | 9 weeks | MP, EL, Cataract op. | 4 weeks | Buckling# | Partially success |
| | | | | Add PPV, MP | |
| 7 | 12 weeks | Buckling, 2′IOL | 12 weeks | Soil, MP, EL | Partially success |
| 8 | 8 weeks | EL, IV SF6, 2′IOL, | 1 week | Soil, MP, EL | Partially success |
| 9 | 13 weeks | EL, 2′IOL | 4 weeks | Soil, MP, EL | Partially success |
| 10 | 12 weeks | Cataract op. | 17 weeks | Refusal | Partially success |
Table 3.
Retinal detachment related to open break(s) and other cause
| Case | Initial diagnosis | Retinal tear site before oil injection | Retinal finding during oil removal | Open break(s) at RD | Other factors |
|---|---|---|---|---|---|
| 1 | PVR | 2 retinal tears at 3′ | − | Reopened | − |
| 2 | PVR | 2 retinal tears at 11′ | Multiple small tears | Iatrogenic tear | − |
| | | | at inferotemporal | & New small tears | |
| | | | Iatrogenic large tear at | | |
| | | | nasal on disc | | |
| 3 | PVR | − | − | − | Anterior PVR |
| 4 | Advanced PDR | 5 retinal tears at 9′ & | − | Reopened | Delayed diagnosis d/t |
| | | 11′ | | | mature cataract |
| 5 | Advanced PDR | 1 retinal tear at 3′ | − | New 2 tears at 7′ | − |
| 6 | Advanced PDR | − | − | − | PVR |
| 7 | Macular hole RD | Macular hole | 2 new retinal tears | Reopened m-hole* | Reverse traction |
| | | | at inf. | | d/t myopic fundus |
| 8 | Macular hole RD | Macular hole | − | Reopended m-hole | Poor RPE function |
| | ARMD | | | | d/t ARMD |
| 9 | Macular hole RD | Macular hole & | − | Reopended m-hole | Reverse traction d/t |
| | | 1 retinal tear at 1′30 | | | myopic fundus |
| 10 | Traumatic RRD | 5 retinal tears | − | New 2 tears at 12′ | High myopia |
| | | at 9′ & 11′ | | | |
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