IS TAMOXIFEN A RISK FACTOR FOR RETINAL VASO-OCCLUSIVE DISEASE?

Abstract

Brief Reports SD, 32.7 ⫾ 4.92 years). All patients had no history of glaucoma or ocular hypertension before silicone oil tamponade. Ocular hypertension was defined as in- traocular pressure (IOP) of ⱖ21 mmHg. Sixteen pa- tients were aphakic, and three patients had compli- cated cataract. The predisposing diseases (reasons for silicone oil tamponade) were traumatic proliferative vitreoretinopathy in 17 cases and rhegmatogenous ret- inal detachment in 2 cases. Acri-Sil-ol 5000 (Acri-tec, Germany) with high viscosity was used for silicone oil tamponade. TREATMENT OF GLAUCOMA SECONDARY TO SILICONE OIL RETENTION X.F. LIN, MD, L.Y. LIANG, M.K. LIN, MD, Z.H. YUAN From Zhongshan Ophthalmic Center, Guangzhou, Guangdong Province, China. Nineteen eyes with secondary glaucoma due to sili- cone oil retention after silicone oil removal are de- scribed. The mean intraocular pressure ⫾ SD was 37.23 ⫾ 6.47 mmHg 7.89 ⫾ 2.75 days after silicone oil removal. In 5 eyes, medical therapy was effective to control intraocular pressure, while the other 14 eyes needed surgery. Cibis was the first to adopt silicone oil in the treat- ment of retinal detachment in 1962. With the rapid development of complicated posterior segment surger- ies, the use of silicone oil has increased, thus greatly improving the prognosis of proliferative vitreoreti- nopathy. However, silicone oil–related complications have also appeared. For example, retention of silicone oil after its removal may lead to secondary glaucoma, which is often overlooked and leads to the adverse consequence of delaying treatment. To study clinical features and to evaluate therapeutic efficacy, we re- viewed 19 cases (19 eyes) of secondary glaucoma due to silicone oil retention after silicone oil removal that occurred from February 2001 to May 2003. General Conditions Silicone oil removal was performed 2 months to 2.3 years (mean ⫾ SD, 17.25 ⫾ 3.16 months) after sili- cone oil tamponade. Indications for silicone oil re- moval were silicone oil emulsification (in the vitreous and anterior chamber) in 9 eyes, secondary glaucoma in 7 eyes (combined with silicone oil emulsification in 5 eyes [emulsification was detected before silicone oil removal in 3, but it was discovered during silicone oil removal in 2]), and band-shaped corneal degeneration in 4 eyes. In two cases, silicone oil removal was performed ⬎1 year after silicone oil tamponade as a result of the patients’ wishes, although no symptoms were identified. In all cases, silicone oil removal was performed via a pars plana entry. First, an infusion cannula was inserted into the vitreous cavity from an incision at the inferotemporal quarter 4.0 mm away from the limbus. Then another pars plana incision of 1.5 mm in length was made at the superotemporal quarter 4.0 mm away from the limbus. Depressing the posterior margin of the incision facilitated the silicone oil outflow. Silicone oil removal and pars plana lensectomy were done simultaneously on one eye with severe complicated cataract and silicone oil in the anterior chamber. Meanwhile, in the eyes with apha- kia and in the eye that underwent silicone oil removal and pars plana lensectomy, the contents of the anterior chamber were also replaced with balanced salt solu- tion. In the other two cases, no additional efforts were made to replace the aqueous humor, because no ob- Patients and Methods Patients Of 19 patients, 17 were males and 2 were females; their ages ranged from 15 to 47 years (mean age ⫾ The authors have no financial or proprietary interest in the study. Reprint requests: Dr. X.F. Lin, Zhongshan Ophthalmic Center, Xian Lie Nan Road 54, Guangzhou, Guangdong Province, China 510060; e-mail: Dragonye2002@yahoo.com.cn RETINA ® , The Journal of Retinal and Vitreous Diseases, encourages authors to submit Brief Reports describing unusual findings, new techniques, and new instruments. Material submitted for consideration in this section of the journal is done so with the assumption that the data provided do not duplicate previously published material and that the material has not been submitted for consideration elsewhere. Each author must sign a disclosure to this effect (see Instructions to Authors for complete wording of transfer letter). Brief Reports submitted for this section of the journal may be subjected to the standard review process that is applied to other material submitted to RETINA ® . Brief Reports should follow the requirements listed in the Instructions to Authors, with the following caveats: Brief Reports should not exceed 4 pages in length; no more than 5 references should be cited; and each Brief Report should include no more than 4 figures.