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Dipal P. Shah, Priya Kalyam, Parisa Emami-Naeini, Marco Zarbin, Neelakshi Bhagat; Outcomes and Complications of Silicone Oil Use in Pediatric Eyes for Complex Retinal Detachment Repair After Open Globe Injuries. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5814.
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To report anatomic outcomes and complications of retinal detachment (RD) repair with silicone oil (SO) tamponade in pediatric eyes after open globe repair.
A retrospective chart review of pediatric patients who underwent pars plana vitrectomy (PPV) between 2003-2010 at New Jersey Medical School with SO tamponade for repair of traumatic RDs as a result of open globe injury.
15 eyes were identified. There were 14 males and 1 female. Mean age of the patients was 9.4 years (range: 1-18). All 15 of the eyes suffered from open globe injuries; 7 (47%) of these from zone III injuries, 2 (13%) from zone II, and 6 (40%) from zone I. At the 6 month examination, the retina was completely attached in 9 (60%) of the 15 eyes after one surgery. The 6 eyes with recurrent RD and proliferative vitreoretinopathy (PVR) underwent a second PPV with silicone oil reinfusion with subsequent anatomic success. Final anatomic outcomes in this study resulted in 11 (73%) out of the 15 eyes achieving an attached retina while 4 (27%) did not.4 (44%) out of the 9 eyes that were completely attached at 6 months underwent SO removal at a mean duration of 10.5 months; 1 (11%) out of these 9 eyes had a recurrent RD after SO removal requiring PPV and reinfusion of SO. The average duration of SO in the 5 (56%) remaining eyes that did not have oil removed was 66 months. Complications noted in these 5 eyes were: PVR (80%); hypotony (60%); corneal opacification (40%); epiretinal membrane (40%); subretinal fibrosis (40%); cataract (20%); oil migration into the anterior chamber (20%); high intraocular pressure (20%); preretinal hemorrhage (20%); retinal pigment epithelial changes (20%).
Retinal reattachment was achieved in 73% of traumatic pediatric eyes that underwent vitrectomy with SO tamponade. One-fourth of the eyes developed recurrent RD once the oil was removed. However, significant complications resulted when silicone oil was not removed. Overall, use of silicone oil can be considered in the management of retinal detachments in pediatric populations suffering from traumatic injury.
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