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M. J. Nobrega, D. C. Souza, S. L. P. Weber, J. M. Z. Viesi, F. J. Novelli; Results After Silicone Oil Removal in Complex Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5223.
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To evaluate anatomical and visual outcomes after silicone oil removal in patients operated on retinal detachment and proliferative vitreoretinopathy in a referential eye-care centre in Joinville, southern Brazil.
retrospective, non-comparative, consecutive case series. Cases included all patients with retinal detachment and grade C posterior proliferative vitreoretinopathy examined and operated on by the same physician (MJN) from January 1997 to August 2006. Cases of retinal detachment associated with trauma, giant tears, viral retinitis or diabetic retinopathy were excluded. The initial surgery, performed in all the eyes, included pars plana vitrectomy, 360-degree scleral buckling, laser endophotocoagulation around the retinal tears and silicone oil infusion in the vitreous cavity. A prophylactic 360-degree peripheral laser photocoagulation was applied one to three months before silicone oil removal.
Twenty-seven patients underwent silicone oil extraction. Nineteen (70,4%) were men and the mean age was 54,1 years-old (range 24-79 yo). Follow-up varied between 47 days and 1141 days (medium 165 days). Twenty-six eyes (96,3%) had the retina attached at the last examination and one (3,7%) had a recurrent retinal detachment after silicone oil removal. Visual acuity improved in 12 patients (44,4%), stabilized in 12 patients (44,4%) and decreased in 3 patients (11,1%). There was a case of severe visual loss after silicone oil extraction (from 20/40 to 20/400), with an indetermined optic disc atrophy.
Silicone oil removal provided good anatomical and visual results in most of the patients. Nevertheless, 3 cases had unfavorable outcomes, particularly one with a severe and unexplained vision loss. Surgeons must be aware of this possibility and analyse the costs and benefits of silicone oil extraction. Prospective and comparative studies are required to assess properly not only the advantage of removing silicone oil but also the safety and efficacy of a previous prophylactic peripheral laser photocoagulation in patients with complex retinal detachments.
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