MANAGEMENT OF RETINAL REDETACHMENT FOLLOWING SILICONE-OIL REMOVAL

The aim of the present investigation was to study the clinical course of eyes presenting with retinal redetachment after silicone-oil remova l (SOR), with special regard being paid to the long-term visual outcom e. Between October 1989 and September 1994, SOR was performed on a con secutive series of 262 eyes that had previously undergone vitrectomy c ombined with silicone-oil injection for complex retinal detachments. T he records of these patients were analyzed retrospectively. The mean f ollow-up period after redetachment following SOR was 26.3 (range 6-45) months. Redetachment occurred in 35 eyes (13.4%), mostly within 1-3 m onths of SOR. Redetachment was not dependent on the surgical procedure or the underlying disease. A total of 24 eyes were revitrectomized an d a stable flat retina was the result in 23 eyes (65.7%). At the lates t follow-up visit, 18 eyes (51.4%) had a visual acuity (VA) of greater than or equal to 0.02 and 14 eyes (40%) had a VA of greater than or e qual to 0.1, In 12 eyes (34.3%) the final VA equalled the best VA reco rded before redetachment an increase in VA occurred in 6 eyes (17.1%) and a deterioration was noted in 17 eyes (48.6%). Only 6 of the 17 eye s that deteriorated had displayed a VA of greater than or equal to 0.0 2 prior to SOR and lost form-ed vision due to redetachment; these 6 ey es represent 17.1% of the eyes presenting with redetachment after SOR and 2.3% of all 262 eyes that had undergone SOR. These observations de monstrate that revitrectomy is an effective treatment for retinal rede tachment after silicone-oil removal. The final failure rate does not a ppear high enough to justify a contraindication for routine removal of silicone oil, especially since it remains a matter of speculation as to whether these eyes would have fared better had removal of silicone oil been avoided.