Abstract
BackgroundSilicone oil tamponade is more frequently reserved for cases of complex retinal detachment. We describe the effects of different variations in oil ratios with the relatively unknown technique of double oil tamponade.MethodsRetrospective case note review of nine patients with complex rhegmatogenous retinal detachment (RD). All cases had both superior and inferior breaks, mostly with associated proliferative vitreoretinopathy (PVR). All cases were treated with pars plana vitrectomy (PPV) and a double silicone oil endotamponade (DSOE) of both heavy silicone oil and conventional ‘light’ silicone oil. Ratios were varied to suit different RD configurations. In vitro observations were studied to help direct these decisions.ResultsAnatomical success was achieved in all cases. Common complications were the same as those seen in single oil tamponade (elevated intraocular pressure, cystoid macular oedema (CMO), cataract and posterior capsule opacification. No single case of recurrent RD was seen whilst mixed oil remained in situ.ConclusionsDouble silicone oil endotamponade is a safe and effective treatment for complex retinal detachments with superior and inferior breaks. Differences in oil ratios can be tailored to best fit the distribution of retinal pathology. In vitro observations may help to inform these choices.
Highlights
Silicone oil tamponade is more frequently reserved for cases of complex retinal detachment (RD) [1]
All patients were treated with 25-gauge pars plana vitrectomy (PPV) followed by double silicone oil endotamponade (DSOE)
Our results demonstrate that DSOE is a safe and effective treatment for complex RDs with superior and inferior breaks
Summary
We describe the effects of different variations in oil ratios with the relatively unknown technique of double oil tamponade. Silicone oil tamponade is more frequently reserved for cases of complex retinal detachment (RD) [1]. Complex RDs with both superior and inferior breaks and/or proliferative vitreoretinopathy (PVR) [3] present a challenge, as neither type of oil provides adequate tamponade [4]. We report a series of such cases who received tamponade with both types of oil simultaneously. This technique has been described [5] but is not widespread in UK vitreoretinal practice. We examined some of the in vitro configurations of these mixtures and reflect on how different oil ratios might be selected to suit different clinical presentations (Fig. 1a-d)
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