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Katherine McCabe, Michael Eric Jansen, Geoff Cloud, Rossana Cheng He, Alexander Barash, Richard B Rosen, Avnish Deobhakta; Silicone Oil Removal: Timing and Retinal Detachment Recurrence. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6575.
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© ARVO (1962-2015); The Authors (2016-present)
Silicone oil is often used as a retinal tamponade after complex retinal detachment repair. Due to long term complications from silicone oil including glaucoma, corneal decompensation, and vitreoretinopathy, it often must be removed from the eye. The optimal time for removal of silicone oil is debated. This retrospective, observational study aims to test the hypothesis that maintaining silicone oil in the eye for a longer period of time is correlated with a decreased risk of recurrent retinal detachment.
This study included all cases of silicone oil removal among clinic patients at New York Eye & Ear Infirmary from 2013-2018. 157 cases were identified, with diagnoses including diabetic tractional retinal detachment, detachment involving proliferative vitreoretinopathy, traumatic retinal detachment, and recurrent retinal detachment. The following data points were recorded: age of patient, type of retinal detachment, previous surgeries, visual acuity, intraocular pressure, lens status, type of silicone oil implanted (1000 centistoke vs. 5000 centistoke), time until silicone oil removal, subsequent corneal or glaucoma surgery, and whether the retina was attached or detached at various time points after silicone oil removal. The association between the timing of silicone oil removal and the likelihood of re-detachment was analyzed using a t-test.
The number of days silicone oil remained in the eye among patients who re-detached after removal (n= 14) was compared to the number of days silicone oil remained in the eye among patients who remained attached after removal (n= 143) using a t-test. Patients who re-detached had oil in the eye for a mean duration of 154.6 (SD= 83) days versus 227.4 (SD= 351) days for those who remained attached (p= 0.0259).
In this patient population, a shorter duration of silicone oil in the eye was associated with an increased likelihood of re-detachment. This finding could potentially suggest that maintaining silicone oil tamponade for a longer period of time may decrease the risk of re-detachment, though this treatment course must be weighed against the risks of glaucoma, corneal decompensation, and other complications.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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