VISUAL OUTCOME AND POST OPERATIVE COMPLICATIONS AFTER SILICONE OIL REMOVAL IN PSEUDOPHAKIC VITRECTOMIZED PATIENTS
Main Article Content
Abstract
OBJECTIVE: To assess visual outcome and post-operative complications after silicone oil removal in pseudophakic vitrectomized patients.
METHODS: This interventional case series study was conducted at Department of Ophthalmology, Medical Teaching Institution Lady Reading Hospital, Peshawar, Pakistan from February 2019 to January 2020. A total of 32 eyes of 32 patients were enrolled in the study after fulfilling inclusion and exclusion criteria using non-random consecutive sampling technique. All patients had pars plana vitrectomy with silicone oil done 6 months ago and were pseudophakic. Silicone oil removal was carried out in all patients and visual outcome and surgical complications assessed on 1st and 14th post-operative day. Final examination was done after six months. Statistical analysis was done by using Statistical Package for Social Sciences (version 21) by applying paired sample t-test.
RESULTS: Amongst 32 patients, 20 (62.5%) were male and 12 (37.5%) were female. Age of the patients ranged from 16 to 60 years with a mean age of 35±13.97 years. Pre operatively mean best corrected visual acuity (BCVA) was 1.45±0.52 Log Mar. On the last post-operative follow up after six months mean BCVA was 1.21±0.55 Log Mar. Visual acuity improved in 24 (75%), remained stable in 3 (9.4%) and worsening in visual acuity was seen in five (15.6%) cases. Visual improvement was statistically significant (p-value 0.001) using paired t-test. Most common complications were retinal detachment (n=4: 12.5%), secondary glaucoma (n=4: 12.5%) and epi-retinal membrane (n=2; 6.3%).
CONCLUSION: Vision improves in majority of pseudophakic patients after silicone oil removal.
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References
Schwartz SG, Flynn Jr HW, Wang X, Kuriyan AE, Abariga SA, Lee WH. Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy. Cochrane Database Syst Rev 2020;5(5);CD006126. https://doi.org/10.1002/14651858.cd006126.pub4
Charteris DG. Proliferative vitreoretinopathy: revised concepts of pathogenesis and adjunctive treatment. Eye (Lond) 2020;34(2):241-5. https://doi.org/10.1038/s41433-019-0699-1
Tseng W, Cortez RT, Ramirez G, Stinnett S, Jaffe GJ. Prevalence and risk factors for proliferative vitreoretinopathy in eyes with rhegmatogenous retinal detachment but no previous vitreoretinal surgery. Am J Ophthalmol 2004;137(6):1105-15. https://doi.org/10.1016/j.ajo.2004.02.008
Cibis PA, Becker B, Okun E, Canaan S. The use of liquid silicone in retinal detachment surgery. Arch Ophthalmol 1962;68(5):590-9. https://doi.org/10.1001/archopht.1962.00960030594005
Azen SP, Scott IU, Flynn Jr HW, Lai MY, Topping TM, Benati L, et al. Silicone oil in the repair of complex retinal detachments: a prospective observational multicenter study. Ophthalmology 1998;105(9):1587-97. https://doi.org/10.1016/s0161-6420(98)99023-6
Federman JL, Schubert HD. Complications associated with the use of silicone oil in 150 eyes after retina-vitreous surgery. Ophthalmology 1988;95(7):870-6. https://doi.org/10.1016/s0161-6420(88)33080-0
Silicone Study Group. Vitrectomy with silicone oil or sulfur hexafluoride gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial. Silicone Study Report 1. Arch Ophthalmol 1992;110:770-9.
Bhende PS, Biswas J, Gopal L. Silicone oil complications. Ophthalmology 2004;111(11):2144-5. https://doi.org/10.1016/j.ophtha.2004.08.003
Abrams GW, Azen SP, McCuen 2nd BW, Flynn Jr HW, Lai MY, Ryan SJ. Vitrectomy with silicone oil or long-acting gas in eyes with severe proliferative vitreoretinopathy: results of additional and long-term follow-up: silicone study report 11. Arch Ophthalmol 1997;115(3):335. https://doi.org/10.1001/archopht.1997.01100150337005
Oliveira-Ferreira C, Azevedo M, Silva M, Roca A, Barbosa-Breda J, Faria PA, et al. Unexplained Visual Loss After Silicone Oil Removal: A 7-Year Retrospective Study. Ophthalmol Ther 2020;9(3):1-13. https://doi.org/10.1007/s40123-020-00259-5
Issa R, Xia T, Zarbin MA, Bhagat N. Silicone oil removal: post-operative complications. Eye (Lond) 2020;34(3):537-43. https://doi.org/10.1038/s41433-019-0551-7
Adelman RA, Parnes AJ, Sipperley JO, Ducournau D, European Vitreo-Retinal Society (EVRS) Retinal Detachment Study Group. Strategy for the management of complex retinal detachments: the European vitreo-retinal society retinal detachment study report 2. Ophthalmology 2013;120(9):1809-13.
Roca JA, Wu L, Berrocal M, Rodriguez F, Alezzandrini A, Alvira G, et al. Un-explained visual loss following silicone oil removal: results of the Pan American Collaborative Retina Study (PACORES) Group. Int J Retina Vitreous 2017;3:26. https://doi.org/10.1186/s40942-017-0079-6
Ismail NS, Phang LK, Min TW, Halim WH, Ali HM. Intraocular silicone oil removal: timing, outcome, and silicone oil complications encountered. Malays J Ophthalmol 2019;1(1):37-49. https://doi.org/10.35119/myjo.v1i1.20
Bassat IB, Desatnik H, Alhalel A, Treister G, Moisseiev J. Reduced rate of retinal detachment following silicone oil removal. Retina 2000;20(6):597-603. https://doi.org/10.1097/00006982-200011000-00002
Hu SQ, Jin HY, Wang Y, Zhu LP. Factors of Retinal Re-detachment and Visual Outcome after Intraocular Silicone Oil Removal in Silicone Oil-filled Eyes. Curr Eye Res 2020;45(6):742-8. https://doi.org/10.1080/02713683.2019.1695841
Hutton WL, Azen SP, Blumenkranz MS, Lai MY, McCuen BW, Han DP, et al. The effects of silicone oil removal: silicone study report 6. Arch Ophthalmol 1994;112(6):778-85. https://doi.org/10.1001/archopht.1994.01090180076038
Velikay‐Parel M, Kiss CG, Ivastinovic D, Richter‐Mueksch S. Encircling band, laser retinopexy and lens removal as standard procedure in complicated retinal detachment shows a good clinical outcome. Acta Ophthalmol 2011;89(7):629-33. https://doi.org/10.1111/j.1755-3768.2009.01763.x
Jonas JB, Knorr HL, Rank RM, Budde WM. Retinal redetachment after removal of intraocular silicone oil tamponade. Br J Ophthalmol 2001;85(10):1203-7.
Tan HS, Dell'Omo R, Mura M. Silicone oil removal after rhegmatogenous retinal detachment: comparing techniques. Eye (Lond) 2012;26(3):444-7. https://doi.org/10.1038/eye.2011.319
Al-Wadani SF, Abouammoh MA, El-Asrar AM. Visual and anatomical outcomes after silicone oil removal in patients with complex retinal detachment. Int Ophthalmol 2014;34(3):549-56. https://doi.org/10.1007/s10792-013-9857-9
Teke MY, Balikoglu-Yilmaz M, Yuksekkaya P, Citirik M, Elgin U, Kose T, et al. Surgical outcomes and incidence of retinal redetachment in cases with complicated retinal detachment after silicone oil removal: univariate and multiple risk factors analysis. Retina 2014;34(10):1926-38. https://doi.org/10.1097/iae.0000000000000204
Lam RF, Cheung BT, Yuen CY, Wong D, Lam DS, Lai WW. Retinal redetachment after silicone oil removal in proliferative vitreoretinopathy: a prognostic factor analysis. Am J Ophthalmol 2008;145(3):527-33. https://doi.org/10.1016/j.ajo.2007.10.015
Nagpal MP, Videkar RP, Nagpal KM. Factors having implications on re-retinal detachments after silicone oil removal. Indian J Ophthalmol 2012;60(6):517.