Abstract
Purpose :
The aim of the present study is to evaluate the different clinical complications associated with vitreous substitutes, especially silicone oil (SO).
Methods :
This is a retrospective, observational and single-center study of consecutive patients operated by pars plana vitrectomy (PPV) between 2015 and 2020 at the Clinical University Hospital of Valladolid due to different vitreoretinal pathologies, such as retinal detachment (RD), epiretinal membrane (ERM), macular hole (MH) or vitreous hemorrhage (VH). The characteristics of the patients and their complications were recorded in an Microsoft Excel database. The statistical analysis was performed with the SPSS program (version 21.0 ).
The mean (± standard deviation) or median was used to describe all continuous variables, and frequencies to explain nominal or categorical variables. Normality was analyzed using the Kolmogorov-Smirnov statistic for data greater than 50 and the Shapiro-Wilk statistic when less. The analysis of the study data was performed with the Chi-square test, establishing significance p<0.05.
Results :
We included 669 surgeries performed on 472 eyes of 424 patients. Their mean age was 60 years (range 8-87) and their follow-up was 25.24±1.02 months. The main cause of primary surgery was retinal detachment or re-detachment in 406 cases (60.8%), followed by epiretinal membrane (14.5%), hemovitreous (12.8%) and macular hole (10.3%).
In 140 surgeries, SO was used as a tamponading agent and in the rest; air, balanced saline or gas. The median time of AS permanence was 7 months (range 1-107). Long-term complications in both groups included acute ocular hypertension in 254 eyes (28.6% vs 20%) and chronic ocular hypertension in 105 interventions (15.7%). Other undesirable events were ERM formation (29.04%), vitreoretinal proliferation (21.41%), retinal re-detachment (10.8%), cystic macular edema (25.4%), corneal decompensation (8.98%), cystic macular edema (25.4%) and posterior synechiae (SPs), all occurring with a higher frequency and statistical significance in the AS group (p<0.01).
Conclusions :
Vitreous substitutes agents used in PPV generate complications that should be recognized early. Among them, SO is the one that causes the most severe complications and adverse events. Hence, future directions in the development of vitreous substitutes are needed.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.