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Hardik Parikh, Neil Kalbag, Marco Zarbin, Neelakshi Bhagat; Characteristics, Demographics, Anatomic and Functional Outcomes, and Complications of Diabetic Tractional Retinal Detachments Treated with Silicone Oil Tamponade. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2339.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the characteristics, demographics, anatomic and functional outcomes, and complications of diabetic eyes with tractional (TRD) or combined tractional/rhegmatogenous retinal detachment (trRD) that underwent pars plana vitrectomy (PPV) silicone oil (SO) tamponade at University Hospital in Newark, NJ between 2006 and 2012.
Retrospective chart review. Exclusion criteria included previous PPV.
Forty eyes of thirty-seven patients were identified. Twenty-three (62%) patients were male. Eleven (30%) patients had type I DM, 23 (62%) had type II, and 3 (8%) others were undocumented. The mean age of the patients was 46.9 years (range 23-68 years). The average follow-up was 22.4 months (range 7 days-6.8 years). Twenty four (60%) eyes presented with a combined trRD. A detached macula was present in 33 (82.5%) eyes. Eyes with macula-sparing TRDs had better pre-op VA (~20/400), final VA (~20/400), and BCVA (~19/200) than those with a detached macula (~20/400, ~HM, and ~5/200, respectively). The mean pre-operative complexity score (CS) of the TRDs was 5.95 (range 4-8). Eyes with lower CSs had a better mean final VA: ~20/400 for CS 4, ~HM for CS 6, and ~1/200 for CS 8. The average BCVA for all 40 eyes was ~5/200, and occurred at a mean of 6.5 months post-op. Eyes of patients on dialysis had poorer final VA (~1/200) than those patients who were not (~5/200). Eyes with 3 or more pan-retinal photocoagulations attained better mean final VA (~5/200) than eyes with 0 pre-operative PRP’s (~1/200). Complications in patients with 6 or more months of follow-up included cataracts (46%), pre-retinal fibrosis (33%), oil migration to anterior chamber (12%), corneal edema (12%), RD (9%), oil emulsification (9%), glaucoma (6%), oil migration under the conjunctiva (6%), subretinal oil (6%), rubeosis iridis (6%), hyphema (3%), and hypotony (3%). In patients with at least 6 months of follow-up, only 4 of 33 (12%) eyes had no complications. Only 10 of 40 (25%) eyes underwent silicone oil removal.
The average complexity score in diabetic eyes that underwent TRD repairs with silicone oil was high, at 5.95. Complication rates with oil tamponade for diabetic TRDs were low in this series.
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