Pars plana vitrectomy with silicone oil in the management of combined rhegmatogenous

Abstract Purpose Rhegmatogenous retinal detachment combined with spontaneous pre-operative choroidal detachment (RDCD) represents a rare but specific entity, which has in the past been associated with a poor prognosis. This study was designed to determine the efficacy of pars plana vitrectomy with silicone oil injection in the management of this very difficult vitreoretinal problem. Methods A retrospective analysis was carried out of 13 eyes of 13 consecutive patients who underwent vitrectomy and silicone oil exchange. Results In a total of 10 eyes (77%) the first procedure produced anatomical success. Two eyes required a further procedure to achieve retinal reattachment, producing a final anatomical success rate of 92%. Conclusion Pars plana vitrectomy with silicone oil exchange is an effective technique for managing RDCD. Key words Choroidal detachment, Pars plana vitrectomy, Rhegmatogenous retinal detachment, Silicone oil Patients with rhegmatogenous retinal detachment are occasionally found to have concurrent choroidal detachment (CD). These patients often present in an atypical way with pronounced uveitis, posterior synechiae, hypotony, deepened anterior chamber and pain. Patients with blue irides often have an apparent change in iris appearance, the affected eye taking a greenish tinge due to a highly proteinaceous aqueous. Retinal detachment may not be diagnosed if the view of the posterior segment is poor. From the point of view of surgical intervention, the presence of spontaneous CD is an important finding. Cases have in the past been associated with a poor prognosis when treated by 'conventional' (Le.