USE OF SILICONE OIL IN THE TREATMENT OF COMPLICATED RETINAL-DETACHMENT - RESULTS FROM 1981 TO 1994

Purpose: To evaluate the advantages and disadvantages of the retention and removal of silicone oil in the treatment of complicated retinal d etachments. Methods: The records of 344 patients (348 eyes) that under went vitrectomy and silicone oil injection for complicated retinal det achments were abstracted and analysed. The anatomical and functional r esults, complications and influencing factors are discussed. The outco me in eyes after removal of the silicone oil was compared with the out come in a comparable group of eyes in which the silicone oil was retai ned. Results: The overall retinal reattachment rate was 63% (220/348). The final vision of 5/300 or better was 52% (115/220) in those eyes w ith totally attached retinas. The silicone oil-related complications i ncluded keratopathy (23%) and secondary glaucoma (11%). Comparing remo val of silicone oil with retention of silicone oil, we found: (i) ther e was no statistical difference in the redetachment rate (19 vs 17%); (ii) oil-removed eyes had a better final vision (P < 0.05); and (iii) keratopathy( 13 vs 23%), secondary glaucoma (11 vs 25%) and optic nerv e atrophy (4 vs 18%) were significantly lower in oil-removed eyes. Con clusion: Silicone oil injection is useful in the treatment of complica ted retinal detachments. For reducing the incidence of complications, early removal of silicone oil is recommended in those cases in which t he retina is attached, all breaks adequately closed and traction relie ved.