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George Azar, Elyse Jabbour, Joelle Antoun, Alexandre Jalkh; VITREORETINAL SURGERY WITH SILICONE OIL INJECTION IN UNCOMPLICATED RHEGMATOGENOUS RETINAL DETACHMENT: CLINICAL AND INTRA-OCLUAR PRESSURE OUTCOMES. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2873.
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© ARVO (1962-2015); The Authors (2016-present)
To study and compare anatomic, visual acuity and intraocular pressure (IOP) outcomes after retinal surgery using 1000- or 5000- centistokes silicone oil (SO).
This is a prospective observational study. We followed 112 patients undergoing uncomplicated rhegmatogenous retinal detachment surgical repair between January 1st, 2006 and April 30, 2012. Mean follow-up was 3.8 years. At all visits, patients had a detailed ocular history, as well as thorough bilateral evaluation, including best-corrected visual acuity (BCVA), anterior segment examination, dynamic gonioscopy, IOP measurement by aplanation and fundus examination. Outcomes were assessed at 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year, then every 6 months.
This study included 112 eyes of 112 patients (76 males, 36 females) that underwent uncomplicated rhegmatogenous retinal detachment repair with vitrectomy and SO injection. One thousand centistokes SO was used in 82 eyes and 5000 centistokes SO in 30 eyes (73.2% and 26.8% respectively). The mean age at the time of intervention was 56.9 ± 11.6 standard deviation (SD) years (range, 21-79 years). All patients were white Caucasians. Demographic characteristics were similar between the two groups. Overall, the incidence of IOP elevation after intervention was 42% by 1 week, 12.5% by 3 months and 6.3% by 6 months. By stratifying our results according to the two weights of silicone used, 51 patients out of 82 in the group 1000 centistokes SO raised their IOP more than 21 mmHg, compared to 16 patients out of 30 in the group 5000 centistokes SO (62% and 53% respectively, p=0.4). No statistically significant difference in IOP elevation was neither found at 1 week, 3 months and 6 months between the two groups (p= 0.75, 0.84 and 0.54 respectively). Rates of corneal abnormality, cataract, SO emulsification as well as anatomical success were also similar. Operative success rate defined as retinal reattachment 6 months after SO removal was 97%. 10 patients (8.9%) needed chronic hypotonic topical treatment for IOP control. Only 4 patients (3.6%) required additional filtrating drainage surgery for IOP control.
Vitreo-retinal surgery with SO injection seems to be an efficient and safe first choice surgical treatment for uncomplicated rhegmatogenous RD regarding long-term control of IOP.
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