Use of silicone oil in the management of complex retinal detachment -- an Indian experience

Abstract

In the management of complicated retinal detachments (RD), temporary silicone oil tamponade has been increasingly used. This study reports results and complications of temporary silicone oil tamponade that was used to treat complicated RD associated with multiple etiologies. Between 1988 and 1998, a total of four thousand four hundred and eighty-eight (4488) eyes underwent vitreous surgery and silicone oil tamponade. Outcome measures were: anatomic and functional success and postoperative complications such as cataract, corneal changes, hypotony, and glaucoma. An eye was considered an anatomic success if there was a complete retinal reattachment or macular attachment. Functional success was defined as attainment of visual acuity of 5/200 or better. Multiple logistic regression analysis was performed to elucidate the relationship between various pre- and postoperative variables and outcome measures. Mean follow-up was 17 months, and median, 8 months. Overall, anatomic success was achieved in 73% of the eyes, and functional success, in 47%. After removal of silicone oil, recurrence of retinal detachment was observed in 9% of the eyes; a high percentage (70%) of eyes attained functional success. Postoperative cataract was observed in 65.3%, abnormal corneas in 21.3%, hypotony in 16.9%, and glaucoma in 16.4% of the eyes. Despite the onset of complications related to silicone oil usage, a high rate of reattachment of the retina was observed following vitrectomy and silicone oil tamponade in the management of complex RD associated with multiple etiologies.