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M. C. Peden, C. W. Sheets, S. Adams, H. D. Vaishnav, R. Ratnakaram; Effect of Silicone Oil on Intraocular Pressure Following Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2222.
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Complications of intraocular Silicone Oil (SO) placement are well documented, including chronic intraocular pressure (IOP) elevation. However, data regarding these complications is quite varied and difficult to extrapolate for an individual practice. The purpose of this study was to assess the effects of SO on IOP in first as well as repeat surgeries.
Clinical outcomes of 100 eyes that underwent primary PPV with instillation of 5000 centistoke SO at the University of Florida between 2000 and 2006 were assessed for (1) pre-existing glaucoma, (2) lens status, (3) pre-operative IOP, (4) IOP at post-operative days (POD) 1, 7, 30, 90, 180,and 360, and (5) need for IOP lowering medication or surgery. Secondarily we looked at 31 eyes that underwent 1 or more repeat PPV’s with SO exchange to see if there was an increased risk of chronic IOP elevation with multiple surgeries.
Thirty-four of the 100 eyes undergoing primary surgery developed elevated IOP with peak prevalence at post-operative day 7. Of these 34 eyes, 19 were treated with glaucoma medications alone while 2 required medication and additional surgical or laser intervention. 13 of these patients had significant elevation in IOP but did not warrant treatment. By POD 180, only 12 eyes required antiglaucoma drops. Average number of medications started was 2.27. Two of the 100 eyes developed hypotony. In the 31 eyes with repeat surgery, 23 eyes had one repeat surgery, six eyes had two repeat surgeries, and two eyes had three repeat surgeries, for a total of 72 surgeries. Of these, 12 surgeries were complicated by post-operative IOP elevation. Seven of these 12 cases required medication to lower IOP, 2 cases required YAG laser PI for pupillary block glaucoma, while no cases required a glaucoma drainage implant. 3 patients had significantly elevated IOP post-operatively, but did not require medical therapy.
Most cases with SO did not have any significant increase in IOP. In those that had increased IOP, the vast majority were easily controlled with medical management. This data suggest that SO can be used in both primary and repeat surgeries without any long term adverse effect on IOP.
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