Use of Heavy Silicon Oil as Intraocular Tamponade for Inferior Retinal Detachment Complicated by Proliferative Vitreoretinopathy: A Multicentric Experience

Maurizio Mete; Barbara Parolini; Emilia Maggio; Giulia Airaghi; Nicoletta De Santis; Massimo Guerriero; Grazia Pertile

doi:10.1159/000531141

Use of Heavy Silicon Oil as Intraocular Tamponade for Inferior Retinal Detachment Complicated by Proliferative Vitreoretinopathy: A Multicentric Experience

Ophthalmologica. 2023;246(3-4):209-218. doi: 10.1159/000531141. Epub 2023 May 26.

Authors

Maurizio Mete¹, Barbara Parolini², Emilia Maggio¹, Giulia Airaghi³, Nicoletta De Santis⁴, Massimo Guerriero⁴, Grazia Pertile¹

Affiliations

¹ Department of Ophthalmology, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.
² Department of Ophthalmology, Eyecare Clinic, Brescia, Italy.
³ Department of Ophthalmology, ASST Valle Olona, Varese, Italy.
⁴ Clinic Research Unit, URC, IRRCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.

PMID: 37245503
DOI: 10.1159/000531141

Abstract

Introduction: This is a multicentric study on the use of heavy silicon oil (HSO) as an intraocular tamponade for inferior retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR).

Methods: 139 eyes treated for RD with PVR were included in the study. 10 (7.2%) were affected by primary RD with inferior PVR, while 129 (92.8%) were affected by recurrent RD with inferior PVR. 102 eyes (73.9%) had received a silicon oil (SO) tamponade in a previous intervention prior to receiving HSO. Mean follow-up was 36.5 (standard deviation = 32.3) months.

Results: The median interval between HSO injection and removal was 4 months (interquartile range: 3). At the time of HSO removal, the retina was attached in 120 eyes (87.6%), whereas in 17 eyes (12.4%), it had re-detached while the HSO was in situ. 32 eyes (23.2%) showed recurrent RD. A subsequent RD relapse was observed in 14.2% of cases with no RD at the time of HSO removal, and in 88.2% if an RD was present at the time of HSO removal. Advancing age showed a positive association with retinal attachment at the end of follow-up, while the risk of RD relapse at the end of the follow-up showed a significant negative association with HSO tamponade duration and with the use of SO rather than air or gas as post-HSO tamponade materials. Mean best corrected visual acuity was 1.1 logarithm of minimum angle of resolution at all follow-up time points. 56 cases (40.3%) needed treatment for elevated intraocular pressure (IOP), with which no clinically relevant variables were associated during follow-up.

Conclusion: HSO represents a safe and effective tamponade in cases of inferior RD with PVR. The presence of RD at the time of HSO removal is a negative prognostic factor for the development of a subsequent RD relapse. According to our findings, in cases of RD at the time of HSO removal, a short-term tamponade should definitely be avoided, in favor of SO. Special attention must be paid to the risk of IOP elevation, and patients should be closely monitored.

Keywords: Heavy silicon oil; Proliferative vitreoretinopathy; Retinal detachment; Tamponade; Vitrectomy.

MeSH terms

Humans
Recurrence
Retina
Retinal Detachment* / diagnosis
Retinal Detachment* / etiology
Retinal Detachment* / surgery
Vitreoretinopathy, Proliferative* / complications
Vitreoretinopathy, Proliferative* / diagnosis