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Hiroaki Ozaki, Jane Huang, Eiichi Uchio; Intraocular pressure abnormalities following silicone oil injection for complicated retinal detachments. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2855. doi: https://doi.org/.
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Intravitreal silicone oil (SO) is used as a tamponade in the management of complicated retinal detachments. Known complications of SO are an increasing intraocular pressure (IOP), secondary glaucoma and hypotony. We have investigated the incidence and character of IOP abnormalities after pars plana vitrectomy with SO for complicated retinal detachments.
Medical records of 200 eyes of 195 patients who underwent pars plana vitrectomy combined with SO for the management of complicated retinal detachment between January 2000 and December 2011 at Fukuoka University Hospital were reviewed. The study included 132 men and 63 women. The average age was 47.9±19.2 years old. The average period of SO tamponade was 7.4±13.3 months, ranging from 0.5 to 84 months. Retinal detachment was due to proliferative vitreouretinopathy in 120 eyes, proliferative diabetic retinopathy in 20 eyes, and others including acute retina necrosis and ocular injury in 60 eyes. Patients with a history of glaucoma, retinopathy of prematurity, acute-onset IOP elevation within 7 days of SO injection were excluded. Hypotony was defined as IOP less than 5 mmHg. Elevated IOP was defined as 3 consecutive measurements of elevated IOP greater than 21 mmHg.
The average IOP was 10.7±4.5 mmHg before the injection of SO, and 12.1±6.2 mmHg after removal of SO. SO was not removed in 23 patients. Hypotony was found in 23 eyes (11.5%) with SO tamponade. Elevation of IOP was found in 21 eyes (10.5%). The average timing of IOP elevation was 5.3 month after SO injection. IOP resulted in normal pressure in 13/21 eyes after SO removal. Additional anti-glaucoma eye drops and/or glaucoma surgeries were carried out for 7/21 eyes with persistently high IOP. SO was not removed in 2/21 eyes because of recurrence of retinal detachments. The emulsification of SO was observed in all eyes with persistently high IOP even after the removal of SO. Emulsification of SO was statistically significant as a risk factor for persistent IOP increase (P<0.05).
SO tamponade induced hypotony in 11.5% and elevation of IOP in 10.5%. IOP was normalized after removal of SO in 63.2% of cases. IOP remained high after removal of SO in 36.8%. Emulsification of SO was a risk factor for persistent high IOP after removal of SO.
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