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Michelle M. Pham, Marco Zarbin, Neelakshi Bhagat; Long-Term Outcomes Of Complex Diabetic Tractional Retinal Detachment Repaired With Silicone Oil Tamponade. Invest. Ophthalmol. Vis. Sci. 2011;52(14):982.
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To assess anatomical and functional outcomes of eyes with long-term placement of 5000-cs silicone oil (SO) for complex diabetic tractional retinal detachment (TRD) repair.
Retrospective chart review of all diabetics who underwent pars plana vitrectomy (PPV) by one surgeon between 2000 and 2009 for TRD or combined rhegmatogenous TRD (RTRD) with SO tamponade. Variables assessed were: age, gender, macular involvement, anatomical retinal status, post-op retinal status, and adverse effects of intraocular silicone oil.
37 eyes were identified with at least 6 months follow-up. Mean follow-up was 28.1 months (range 6-71 months). There were 22 males, 15 females. Average age was 45.9 years. Ten eyes had RTRD. Macula-involving RD was found in 35 eyes. All but 3 eyes were successfully repaired with one surgery; 3 eyes (8%) developed proliferative vitreoretinopathy (PVR). Only six eyes (17%) had oil removal (post-op months 4-35). The remaining 31 eyes that did not have oil removed were due to various reasons: patient deferred surgery (19 eyes, 61% ), extended delay in follow-up (4 eyes, 12%), not recommended due to no light perception (NLP) vision (3 eyes, 9%), and not recommended due to ischemic retina deemed unlikely to tolerate surgical stress (5 eyes, 15%). 21 of 37 eyes (57%) had no complications from long-term silicone oil placement. Complications noted in the remaining 16 eyes included: oil migration in the AC (1 eye); corneal decompensation (1 eye); idiopathic uveitis (3 eyes); band keratopathy (1 eye); iris bombe with high intraocular pressure (1 eye). The iris bombe resolved with laser iridotomy and topical glaucoma drops. Three eyes developed a rapidly progressive cataract requiring extraction within 1 year post-operatively; 6 eyes required cataract extraction within 2 years post-operatively. No eye was noted with either hypotony or emulsified oil.
Retinal reattachment was achieved in the majority of eyes (92%) via vitrectomy with silicone oil. Most of the complications were noted within 1 year post-operatively. Rapid progression of cataract was the most common complication among our group of diabetic eyes. Other adverse effects of silicone oil were negligible in the long-term.
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