OUTCOMES OF PRIMARY UNCOMPLICATED RHEGMATOGENOUS RETINAL DETACHMENT REPAIR USING SILICONE OIL TAMPONADE IN VITREORETINAL SURGERY

Abstract

In a prospective observational study, we aimed to determine anatomical and functional outcomes, as well as possible complications, following pars plana vitrectomy (PPV) with silicone oil (SO) tamponade for primary, uncomplicated rhegmatogenous retinal detachments. This study was conducted from August 2023 to November 2023. During the study, 32 patients underwent surgical repair through PPV and SO injection. PPV over scleral buckling was chosen when cataracts or vitreous hemorrhages hindered proper fundus visualization. Patients received comprehensive ocular assessments, including best-corrected visual acuity, anterior segment examination, IOP measurements via applanation, and fundus examinations at different intervals: 1 day, one week, one month, and three months. Intraocular pressure exceeding 21 mmHg was defined as increased IOP. Our study included 32 patients (22 men and ten women) of Asian ethnicity who underwent retinal detachment repair by PPV and SO injection. The patients had an average age of 57.8 ± 10.1 years (34–76 years) at the time of intervention. The follow-up period was three months. An anatomical success rate, defined as retinal reattachment three months after SO removal, was achieved in 29 eyes (90.6%). Final best-corrected visual acuity (BCVA) improved 26 looks (81.2%), with a mean gain of 3 Snellen lines. BCVA remained unchanged in 4 eyes (12.5%) and deteriorated in 2 eyes (6.3%), with a mean loss of 2 Snellen lines. During the 3-month follow-up period, 17 eyes (53.1%) experienced increased intraocular pressure (IOP). Out of these, 15 patients had transient ocular hypertension, requiring topical treatment during the immediate postoperative period (within one month). Only one eye (5.9%) required filtrating drainage surgery for IOP control. Notably, no eyes developed optic neuropathy due to elevated IOP during this short-term follow-up. Pars plana vitrectomy (PPV) combined with silicone oil (SO) injection is a safe and effective surgical approach for treating primary uncomplicated rhegmatogenous retinal detachment. Our series indicates that PPV and SO injection lead to good anatomical and functional outcomes, with high reattachment rates and low rates of proliferative vitreoretinopathy. Although cataract formation and elevated intraocular pressure (IOP) are common complications, they can be successfully controlled.