Author: Ömer Özer (Turkey)
Co-authors: Özer Dursun, Erdem Dinç, Mustafa Vatansever, Özlem Yıldırım, Özgün Oktay, Pınar Eröz
Purpose
The aim of this study was to evaluate optical coherence tomography (OCT) findings in eyes that underwent pars plana vitrectomy for rhegmatogenous retinal detachment (RRD) and using silicone oil tamponade.
Setting/Venue
Forty-two eyes of 42 patients who were used pars plana vitrectomy and silicone oil tamponade for rheumatogenic RD between March 2017 and March 2020 in Department of Ophthalmology, Faculty of Medicine, Mersin University were included in the study.
Methods
Cases with ocular pathology other than cataracts, those who had undergone surgery for any reason other than cataract surgery, those who had membrane peeling and whose anatomical success could not be achieved, those who did not come for regular controls or whose records could not be reached were excluded from the study. Anatomical success was defined as retinal attachment after vitrectomy for RD and removal of silicone oil tamponade. File records and optical coherence tomography sections (OCT) (Heidelberg HRA-OCT Spectralis®, Heidelberg Engineering GmbH, Heidelberg, Germany) of all patients included in the study were retrospectively scanned and examination findings, macular thickness, presence of degeneration in the inner retinal layers, ellipsoid zone/external limiting membrane (EZ / ELM) continuity, presence of subretinal fluid and accompanying vitreomacular pathologies were recorded. In addition, the time elapsed between the onset of symptoms and surgery was evaluated. The first and sixth months after silicone oil injection and the first and sixth months after removal of silicone oil were re-evaluated, and OCT findings obtained from the operated eyes were compared with the data obtained from fellow eyes.
Results
The patients in this study 29 were male (69%), 13 were female (31%), and the mean age was 62.1 ± 9.09 years. At admission, 20 eyes (47.6%) were phakic and 22 eyes (52.4%) were pseudophakic. Macular involvement was detected in 23 eyes (54.76%) and was not detected in 19 eyes (45.24%). When the anatomical locations of the tears were evaluated, found that the most common localization was in the supertemporal with 42.5%, followed by the inferotemporal with 22.7%, the superonasal with 22.7% and the inferonasal with 6.9%. The mean follow-up period of the patients included in this study was 18.09 ± 8.24 months, and the mean duration of silicone oil tamponade in the operated eyes was 253.21 ± 113.32 days. Preoperative BCVA was 0.09 ± 0.16, 0.14 ± 0.1 at first month postoperatively, 0.29 ± 0.23 at first month after silicon oil removal, and 0.32 ± 0.25 at the sixth month after silicon oil removal. Visual acuity increased significantly compared to before surgery (p <0.0001 for each parameter). In addition, an antiglaucomatous drop was required in 20 (47.6%) eyes that underwent surgery. The central retinal thickness (CRT) in fellow eyes was 289.54 ± 33.45 µm, in silicone oil injected eyes 268.42 ± 62.95 µm in the first month and 291.64 ± 65.09 µm in the sixth month. After silicon oil removal, CRT was 286.04 ± 68.54 µm in the first month and 322.06 ± 64.91 µm in the sixth month. The difference between the CRT values of the eyes injected with silicone oil in the sixth month and the CRT values in the sixth month after silicone oil removal (p <0.0001). After silicon oil removal, degeneration in the inner retinal layers in 19 eyes (45.2%) and impairment in EZ / ELM integrity in 12 eyes (28.6%) were detected. While there was no vitreoretinal interface problem in 32 eyes (76.2%), epiretinal membrane (ERM) in 7 eyes (16.7%), macular hole in 2 eyes(4.8%), macular hole development with ERM in 1 eye (2.4%). In addition, macular edema/subretinal fluid was observed in 6 eyes (14.3%) during follow-up. A statistically significant relationship was found between the duration of silicone oil tamponade and the presence of macular edema-subretinal fluid (p = 0.003).
Conlusions
This study shows that the use of silicone oil in patients with rhegmatogenous RD has effects on central retinal thickness, visual acuity and OCT findings. However, many of these effects were not found to be related to the duration of silicone oil tamponade. However, in cases where silicone oil is used as a tamponade, thought that it may be beneficial to remove this oil from the eye in the early period. In addition, it would be appropriate to evaluate the possible effects of silicone oil on retinal tissue with larger patient series and longer patient follow-up.
Financial Disclosure
There are no financial conflicts of interest to disclose.
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