SILICONE OIL IN THE REPAIR OF COMPLEX RETINAL DETACHMENTS - A PROSPECTIVE OBSERVATIONAL MULTICENTER STUDY

Objective: This study aimed to report anatomic and visual acuity outco mes and complications after 1000-centistoke silicone oil was used as a retinal tamponade for the treatment of complex retinal detachments. D esign: Prospective observational multicenter study conducted at commun ity and university-based ophthalmology clinics. Participants: The stud y cohort consisted of 2439 patients (2573 eyes) treated for complex re tinal detachments associated with cytomegalovirus (CMV) necrotizing re tinitis or a non-CMV etiology, including proliferative diabetic retino pathy, giant retinal tears, proliferative vitreoretinopathy, or ocular trauma. Intervention: Vitrectomy surgery was performed for complex re tinal detachment with 1000-centistoke silicone oil as the retinal tamp onade. Main Outcome Measures: Anatomic outcomes were complete retinal attachment and macular attachment. Visual acuity outcomes were ambulat ory vision (greater than or equal to 4/200) and preservation of preope rative visual acuity, Complications were rates of secondary intraocula r pressure elevation (greater than or equal to 30 mmHg), hypotony (les s than or equal to 5 mmHg), corneal opacification (including band kera topathy, corneal edema, and corneal abrasions), oil emulsification, an d cataract, Outcomes were assessed 6, 12, and 24 months after surgery. Results: At the 6-month examination, the retina was completely attach ed in 178 (78%) of 228 CMV eyes and in 855 (70%) of 1219 non-CMV eyes. The macula was attached in 216 (95%) of 228 and 1062 (89%) of 1189 CM V and non-CMV eyes, respectively. Ambulatory vision was noted in 151 ( 65%) of 234 CMV eyes and in 480 (38%) of 1251 non-CMV eyes. Visual acu ity was preserved in 106 (46%) of 230 and 1035 (84%) of 1229 CMV and n on-CMV eyes, respectively. The corresponding rates of complications fo r CMV and non-CMV eyes were: elevated intraocular pressure, 0 (0%) of 196 and 35 (3%) of 1196; hypotony, 11 (6%) of 196 and 228 (19%) of 119 6, corneal opacity, 13 (6%) of 229 and 326 (26%) of 1248; emulsificati on, 3 (1%) of 211 and 29 (3%) of 959; and cataract in phakic eyes, 118 (64%) of 185 and 50 (63%) of 80. Conclusions: Retinal reattachment wa s achieved in the majority of eyes using vitrectomy and silicone oil r etinal tamponade. Complication rates generally were less frequent in C MV eyes, but follow-up was shorter in this group of patients, largely because of reduced life expectancy, Cataract frequently developed in p hakic eyes of study patients. Use of 1000-centistoke silicone oil can be considered in the management of complex retinal detachments associa ted with multiple etiologies.