Purchase this article with an account.
Svenja Deuchler, Helge Krueger, Michael Koss, Pankaj Singh, Frank Koch; Retinal Re-Detachment after Silicone Oil Removal: Destiny or Beat the Enemy?. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6146.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To improve vitreoretinal service by introducing strategies to counteract potentially upcoming complications as retinal redetachments after silicone oil removal.
Based on the pathbreaking work of Herbert and Williamson1 we started to follow up retinal detachments settled with a silicone oil fill retrospectively (n = 119, silicone oil removal in 2008/2009).The indications for surgical intervention in our group included a rhegmatogenous retinal detachment (RRD) in 68% and a proliferative diabetic vitreoretinopathy (PDVR) in 32%.
Besides criteria already published (preoperative visual acuity, axial lengths, activity of proliferative vitreoretinopathy (PVR), previous unsuccessful retinal detachment surgeries, lasercoagulation before silicone oil removal) 2-4 contributing to the outcome of surgery, we detected the poor quality of pre-, intra- and postoperative documentation to be a major hurdle for the decision, timing and selection of procedures to remove the silicone oil (n = 99, 83%). Several infrequently recorded (1,7% - 95 %) criteria had a significant impact onto the timing of silicone oil removal and the decision to add laser and/or membrane peeling before or during silicon oil removal: the history of retinal detachment, the duration and control of diabetes mellitus, the thickness of the detached retina and the intraoperative quality of laser response a well as the involvement of the macula documented with drawings, fundus photography or OCT. Furthermore, there is a better surgical outcome if primary and secondary service are in the hands of the same surgeon.
Retinal redetachments after silicone oil removal are not fateful. In particular, improved documentation assists to set up a better primary retinal detachment service and more properly performed silicone oil removal interventions: this is of medicoethical interest in the first place and also economically important since a silicone oil removal procedure vs. a revision surgery come along with substantially different efforts (time, equipment ) and costs for the health care provider.References 1. Herbert and Williamson. Eye 21: 925-929 (2007). 2. Jonas JB et al. Br. J. Ophthalmol 85: 1203 - 7 (2001). 3. Lam RF et al. Am J Ophthalmol. 145: 527 - 533 (2008). 4. Pavlovic S et al. Opthalmologe 92: 672 -6 (1995)
This PDF is available to Subscribers Only