Silicone Oil Tamponade in Rhegmatogenous Retinal Detachment: Functional and Morphological Results

Abstract

<b>Purpose</b>: To evaluate the functional and morphological outcomes of patients with SO tamponade due to primary rhegmatogenous retinal detachment (primRD) and recurrent rhegmatogenous detachment (recRD).<b>Methods</b>: Seventy-five eyes were enrolled in this prospective study between January 2009 and December 2016. Patients with primRD and recRD were evaluated in a complete ophthalmic examination including best-corrected visual acuity (BCVA) and OCT before and after silicone oil removal (SOR).<b>Results</b>: The primRD group comprised 35 eyes and the recRD group 40 eyes with a duration of SO tamponade of 9 ± 4/12 ± 11 months in the primRD/recRD groups (<i>p</i> = .088). The preoperative OCT revealed a high rate of morphological changes such as ERM (primRD: 24%; recRD: 69%) and CME (primRD: 10%; recRD: 55%) in the recRD compared with the primRD group (ERM: <i>p</i> = .18; CME: <i>p</i> = .04). No such difference was observed postoperatively. Disruption of the ellipsoid zone (EZ) was similar in both groups (primRD: 52%; recRD: 72%) before SOR and was restored in 66%/58% (primRD/recRD) after SOR. No difference was found regarding pre- and postoperative VA (0.91 ± 0.54/0.90 ± 0.54logMAR primRD/recRD preoperative; 0.76 ± 0.56/0.71 ± 0.53logMAR primRD/recRD at the last follow-up; <i>p</i> = .96/<i>p</i> = .70). EZ integrity (0.43 ± 0.31logMAR) was associated with better functional results than an interrupted EZ (0.86 ± 0.43logMAR; <i>p</i> < .001). A significant positive correlation of the duration of SO tamponade and the final VA was found in the primRD (r = 0.396, <i>p</i> = .02) whereas none in the recRD group (r = 0.196; <i>p</i> = .31).<b>Conclusion</b>: Morphological changes including ERM and CME were more pronounced in the recRD group, but only before SOR. Interestingly, the pre- and postoperative BCVA were similar in both groups with EZ integrity being a factor of good functional outcome. The duration of SO tamponade had a statistically significant negative impact on the postoperative VA in the primary detachments.