Faculty Collaboration Database

The effects of silicone oil removal. Silicone Study Report 6. Arch Ophthalmol 1994 Jun;112(6):778-85

Date

06/01/1994

Pubmed ID

8002836

DOI

10.1001/archopht.1994.01090180076038

Scopus ID

2-s2.0-0028309554 (requires institutional sign-in at Scopus site)   170 Citations

Abstract

OBJECTIVE: To evaluate the advisability of removing silicone oil from eyes after surgery for severe (with a classification of at least C-3) proliferative vitreoretinopathy.

DESIGN: Subgroup analysis of the Silicone Study, a randomized, multicentered, surgical trial.

SETTING: Community- and university-based clinics.

PATIENTS: Two hundred twenty-two eyes with severe proliferative vitreoretinopathy followed up in the Silicone Study.

INTERVENTIONS: Vitrectomy for proliferative vitreoretinopathy with silicone oil as the intraocular tamponade.

OUTCOME MEASURES: Changes in visual acuity, recurrent retinal detachment, and incidence of complications.

RESULTS: Ninety-nine (45%) of 222 eyes had surgery for silicone oil removal (oil-removed eyes). Compared with the eyes that did not undergo silicone oil removal (oil-retained eyes) evaluated at a comparable time after oil injection, oil-removed eyes at the examination prior to oil removal were more likely to be attached (85% vs 40%; P < .0001), have a visual acuity of 5/200 or greater (63% vs 35%; P < .0001), and not be hypotonous (5% vs 22%; P < .001). There was no association between the length of oil retention and incidence of recurrent retinal detachment after oil removal. Eyes with attached retinas at the time of oil removal generally improved in visual acuity at the last follow-up examination (P < .0001), which was not evident in eyes with detached retinas at the time of oil removal. In a matched-pair cohort analysis comparing both sets of eyes, there was an increased risk for recurrent retinal detachment at the last follow-up examination in the oil-removed eyes (odds ratio [OR], 2.1; P = .09). However, overall visual acuity improved for oil-removed eyes in 19 (29%) of 66 pairs and for oil-retained eyes in one (2%) of 66 pairs (OR, 19.0; P < .0001). Although nonsignificant, incidence rates of keratopathy (OR, 0.5) and hypotony (OR, 0.5) were lower in oil-removed eyes.

CONCLUSION: Removal of silicone oil in anatomically successful eyes significantly increases the likelihood of improved visual acuity with a slight increase in the likelihood of recurrent retinal redetachment. There was a trend for a reduction in the incidence of complications in the oil-removed eyes.

Author List

Hutton WL, Azen SP, Blumenkranz MS, Lai MY, McCuen BW, Han DP, Flynn HW Jr, Ramsay RC, Ryan SJ

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Cohort Studies
Drainage
Eye Diseases
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications
Recurrence
Retinal Detachment
Retinal Diseases
Silicone Oils
Visual Acuity
Vitrectomy
Vitreous Body