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Natalia Alpizar-Alvarez, Lihteh Wu, Jose A Roca, Francisco Rodriguez, Arturo Alezzandrini, Gustavo Alvira, Raul Velez, Hugo Quiroz-Mercado, J Fernando Arevalo, Martin Serrano, Pan American Collaborative Retina Study Group; Un-explained Visual Loss Following Silicone Oil Removal. Results of the Pan American Collaborative Retina Study (PACORES) Group.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2335. doi: https://doi.org/.
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To report the incidence and clinical features of patients that experienced un-explained visual loss following silicone oil (SO) removal.
Multicenter retrospective study of patients that underwent SO removal during 2000-2012. Visual loss of ≥ 2 lines was considered significant.
A total of 324 eyes underwent SO removal during the study period. 34 (10.5%) eyes suffered a significant visual loss following SO removal. Eleven (3.4%) of these eyes lost vision secondary to known causes such as retinal redetachment and proliferative vitreoretinopathy (7 eyes), vitreous hemorrhage secondary to diabetic retinopathy (3 eyes) and glaucoma (1 eye). In the remaining 23 (7.1%) eyes the loss of vision was not explained by any other pathology. 15 of these 23 patients (65.2%) were male and 8 (34.8%) were female. The mean age of this group was 51.8 (16-73) years. Systemic co-morbidities included 1 patient with cardiovascular disease, 7 with diabetes mellitus, and 7 with systemic hypertension. In 11 patients 5000cs SO was used and in 12 eyes 1000cs SO was used. A multivariate analysis comparing eyes with visual loss and those without visual loss identified intraocular pressure and length of time of silicone oil tamponade as factors associated with visual loss. Eyes that lost vision had a mean IOP while the eye was filled with SO of 16.8 mmHg (11-20). The length of time that the eye was filled with SO was 8 months (3-24). In comparison, eyes that did not experience visual loss had a mean IOP of 15.6 mm Hg (10-24, p<0.005) and a mean tamponade duration of 4.8 months (2-72, p<0.005).
Severe visual loss after SO removal was observed in 7% of patients with otherwise good visual potential.Factors associated with unexplained visual loss included IOP and SO tamponade duration.
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