RELAXING RETINOTOMY WITH SILICONE OIL OR LONG-ACTING GAS IN EYES WITHSEVERE PROLIFERATIVE VITREORETINOPATHY SILICONE STUDY REPORT 5

In the Silicone Study, 117 of 404 eyes (29%) with severe proliferative vitreoretinopathy (greater-than-or-equal-to C-3, full-thickness retin al folds in three or more quadrants) enrolled in the study were treate d with vitrectomy, underwent a relaxing retinotomy, and were randomly assigned to treatment with long-acting gas or silicone oil. Forty-six eyes (20%) had undergone no previous vitrectomy (group 1); 71 eyes (42 %) had undergone previous vitrectomy (group 2) with intraocular gas ta mponade (P < .001). Group 1 eyes not undergoing retinotomy had better anatomic (six months) and visual (six and 24 months) outcomes and less hypotony (six months) than eyes that did regardless of tamponade (P < .05). For eyes undergoing retinotomy, silicone oil decreased the like lihood of hypotony (six months, P < .05). These differences were not f ound in group 2 eyes. We conclude that eyes undergoing a vitreous oper ation for the first time for the treatment of proliferative vitreoreti nopathy can in most instances be successfully treated by conventional techniques without the need for relaxing retinotomy. Retinotomy may be required more often in patients undergoing repeat vitreous surgery fo r proliferative vitreoretinopathy, in which case both silicone oil and long-acting perflouropropane gas appear to be equally effective.