Abstract
Purpose :
Purpose: To review and examine data on patients that have had unexpected poor visual acuity outcomes (PVAO) following pars plana vitrectomy (PPV) with silicone oil tamponade (SOT) for retinal detachment (RD) in past 2 years.
Methods :
Methods: Sterling IRB approval was obtained for performance of a retrospective case series. All retinal surgeons in a single retinal specialty practice were asked to forward any patient names in past 2 years where visual acuity outcomes were unexpectedly poor following silicone oil removal in cases limited to macula on retinal detachment. The medical records were reviewed and queried for age, sex, surgical diagnosis, pre-oil visual acuity, duration of oil retention, post removal oil visual acuities at 3 months, 6 months and 12 months, lens status pre and post op, co-existing macular pathology, optical coherence tomography (OCT) review at 6 and 12 months, and other testing including electroretinagram, automated visual field, and angiography.
Visual acuity was converted to logmar for calculations, and averages with standard deviation were used for most other categories. Statistical testing with paired t test was used for pre-silicone visual acuity versus post silicone oil removal visual acuity at each of 3 months, 6 months, and 12 months to test the null hypothesis.
Results :
Results: A total of 5 patients were identified who underwent macula on RD repair in 2017-2019 and experienced PVAO with SOT. All patients were male (mean age 63.4 years, range 56-76, SD +/- 7.5 years). Duration of SOT was on average 3.8 months (range of 3-5 months, SD of +/- .836). Log Mar VA prior to surgery with was a mean of 0.5112 (range 0.176-1.0, SD of +/-0.318). Post removal of SO logmar acuities for 3, 6, and 12 months measured 0.835 (0.176-1.0, SD +/- .368), 0.86 (0.301-1.0, SD of .312), 0.869 (0.301-1.3, SD +/- .459) respectively. There was no statistically significant difference between the preoperative visual acuity and post-operative visual acuity at 3 months (P=0.239), 6 months (P=0.179), or 12 months (P=0.425). 4/5 showed some OCT abnormalities at fovea at level of ellipsoid line. Other testing was inconclusive.
Conclusions :
Conclusion: These 5 cases of PVAO with SOT lost on average approximately logmar 0.3 in VA and suggest damage at the level of the ellipsoid line on OCT maybe linked to the outcomes.
This is a 2020 ARVO Annual Meeting abstract.