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Hendrik Schwarzer, Babac Mazinani, Niklas Plange, Peter Walter, Gernot Roessler; Complications in Heavy Silicone Oil Surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3325.
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To demonstrate development and complications in heavy silicone oil (HSO) surgery in 100 eyes following primary vitreoretinal surgery.
100 eyes were included in this retrospective study in which two different types of heavy silicone oil (HSO) were used, Oxane®HD (Bausch & Lomb, n=27) and Densiron®68 (FLUORON, n=73) respectively. Indication diagnoses were retinal detachments (n=74), complicated macular holes (MH) (n=21) and open globe injuries (n=5). HSO removal was performed after a mean period of 20.2±19.04 weeks. Mean follow-up time was 35.9±51.78 weeks. In 36 eyes silicone oil surgery was combined with cataract extraction, either combined with HSO insertion or removal. Before and after surgery routine examinations included testing of the best corrected visual acuity (BCVA), slit lamp examination, indirect funduscopy, intraocular pressure (IOP) measuring using Goldmann applanation tonometry.
The mean IOP before HSO surgery was 13.3±5.59mmHg and raised to an average maximum of 23.3±8.53mmHg postoperatively (p <0,001) with a range between 4 and 50mmHg. The mean IOP before HSO removal was 15.8±7.15mmHg and after removal 13.1±4.46mmHg (p=0.001). The difference of IOP before HSO surgery and after HSO removal was statistically not significant (p=0.86). Secondary IOP raise due to emulsification of the silicone oil endotamponade was seen in 29 eyes after a mean time of 7.8±4.53 weeks. Other complications being observed with HSO installed were persistent corneal erosion (n=3) and prolonged anterior chamber inflammation (n=29) out of which the majority was recurrent after HSO removal. In n=3 eyes recurrent retinal detachment occurred with HSO installed while there were 10 recurrent retinal detachments after HSO removal. In 18 eyes with poor functional prognosis the silicone oil remained permanently for stabilisation. In all other eyes HSO surgery led to satisfactory functional and anatomical results.
According to our analysis HSO surgery might deliver satisfying results in complicated cases of ophthalmological surgery. After HSO removal a prior secondary elevated IOP could be normalised. In most eyes the retinal situation remained stable after HSO removal. However, some severe complications that might occur in the course of time need special attention and treatment and should always be taken into account when making the decision to use HSO in complicated retinal surgery.
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