Abstract
Purpose: :
To determine if better visual rehabilitation can be achieved by use of silicone oil as vitreous substitute in monocular patients undergoing pars plana vitrectomy.
Methods: :
Charts of patients who underwent pars plana vitrectomy by one surgeon from 1/1/2005 to 10/1/2007 were reviewed. Patients who had a vision of hand motion or worse in the non-operated eye and who received silicone oil in the operated eye as a vitreous substitute were selected. Charts of these patients were reviewed. Pre-operative vision and post-operative vision over the course of the follow-up period was noted.
Results: :
Thirteen monocular patients were identified (fellow eyes hand motions or worse). The indication for surgery in the study was either rhegmatogenous retinal detachment (n=7) or tractional retinal detachment (n=6). The mean follow-up period was 6 months, +/- 5 months. 7 eyes ( 54%) had vision of count finger or better on post-operative day one; 9 eyes (75%) had vision of count finger or better at post-operative week one. One patient had increased intraocular pressure; due to poor compliance and follow-up, the patient eventually lost vision completely. None of the other patients had oil related complications (e.g., corneal decompensation, oil emulsification or medically uncontrolled glaucoma) during the study period. Silicone oil was removed in two patients 6 and 10 months after surgery without any subsequent complications.
Conclusions: :
The use of gas tamponade following vitrectomy significantly impairs vision postoperatively for up to 2-3 weeks when using SF6 and for up to 5-6 weeks when using C3F8 . The use of silicone oil following vitrectomy in the good eye of monocular patients may allow for quicker visual rehabilitation, since visual rehabilitation often occurs within the first week after surgery with oil tamponade.
Keywords: vitreoretinal surgery • retinal detachment • vitreous substitutes