Anatomical and functional outcomes after heavy silicone oil tamponade in vitreoretinal surgery for complicated retinal detachment: a pilot study.

摘要

PURPOSE: To evaluate the effectiveness and safety of a heavy silicone oil (HSO) tamponade for complicated retinal detachment (RD) surgery. DESIGN: Prospective consecutive interventional case series study. PARTICIPANTS: The study included 26 patients with RD complicated by severe proliferative vitreoretinopathy (PVR) in the inferior quadrants. METHODS: All patients underwent pars plana vitrectomy with an internal tamponade using HSO. This tamponade was obtained by mixing 30% by volume perfluorohexyloctane and 70% by volume silicone oil, 1000 millipascal-seconds (polydimethylsiloxane 1000). MAIN OUTCOMES MEASURES: Anatomical and functional results and complications at 1 year of follow-up. RESULTS: Twenty-four of 26 patients achieved anatomical success, defined as complete retinal reattachment. Postoperative visual acuity (VA) values ranged from hand movements to 20/25, with 69.2% of patients obtaining VA better than 20/400. Postoperative complications included early postoperative ocular hypertension in 30.7% of cases, which was easily controlled. Dispersion was noted in 1 case and was not felt to be significant. A cataract requiring surgical removal developed in 2 cases, and an after cataract developed in 3 cases. CONCLUSIONS: In this pilot study, the HSO tamponade obtained by mixing 30% perfluorohexyloctane and 70% polydimethylsiloxane 1000 was associated with a high rate of anatomical success after vitrectomy in cases of RD complicated by severe PVR (greater than CP-6 and greater than CA-6 [updated Retina Society PVR classification]).