Surgical Outcomes of Complicated Retinal Detachments using Heavy Silicone Oil as an Internal Tamponade

Purpose: To evaluate the anatomical and functional outcomes of using heavy silicone oil as an internal tamponade for complicated cases of retinal detachment associated with proliferative vitreoretinopathy involving inferior retinal quadrants Methods: 55 eyes from 55 patients with complicated retinal detachments enrolled in this interventional case series study. All eyes underwent standard three-port pars plana vitrectomy with endolaser photocoagulation and heavy silicon oil injection. Patients were categorized in traumatic and nontraumatic groups based on underlying retinal pathology. Anatomical and functional outcomes as well as complications were evaluated during 14 months (mean follow-up was 10.3 months), postoperatively. Results: 55 patients, 11 women, and 44 men with a mean age of 37.18±24.2 years (from 4 to 104 years) underwent pars plane vitrectomy with heavy silicone oil injection. Mean preoperative logMAR visual acuity was 2.24 (±0.78) which significantly improved to 1.55 (±0.63) (P<0.005). Retinal redetachment occurred in 11 (20%) at early postoperative period (first month postoperatively) that was successfully managed by reoperations. Heavy silicone oil was removed in 39 (70%) patients after a mean of 5.8 months. Retinal reattachment was ultimately achieved in 37 (67.3%) patients after a mean of 2.3 operations per patient. Reattachment rates were significantly lower in traumatic (48%) compared to nontraumatic (83.3%) group (P=0.038). Intractable glaucoma, retinal redetachment due to proliferative vitreoretinopathy and band keratopathy were among the observed complications. Conclusion: Heavy silicon oil internal tamponade is a safe and effective therapeutic modality in complicated retinal detachments associated with pathologies affecting inferior retinal quadrants.