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Impressum
Silicone Oil Endotamponade for Complex Retinal Detachments in Pediatric and Adolescent Patients
1Degenring R., 2Lang P., 1,2Jonas J. B.
1Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg; 2Department of Ophthalmology and Eye Hospital, University Erlangen-Nürnberg, Erlangen, Germany
Purpose: Since the development of pars plana vitrectomy for treatment
of complicated retinal detachment and proliferative vitreoretinopathy,
silicone oil has increasingly been used in adult patients to tamponade
the retina. The purpose of the present study was to assess the clinical
outcome of young patients undergoing pars plana vitrectomy and receiving
a silicone oil endotamponade.
Patients and Methods: The retrospective clinical interventional
consecutive case series study included 26 patients of an age of less 18
years who underwent pars plana vitrectomy with silicone oil endotamponade
as treatment of proliferative vitreoretinopathy (n=26) due to ocular trauma
(n=11) or rhegmatogenous retinal detachment (n=15). Mean age was 10.65
± 4.87 years (Min.-Max.: 1-17 years). All surgeries were performed
by the same surgeon. Mean follow-up time was 10.74 ± 17.6 months
(Min.-Max.: 0.2- 75.8 months; Median: 3.17 months). Main outcome measures
were preoperative and postoperative visual acuity and intraocular pressure,
frequency of emulsification of silicone oil, corneal problems due to silicone
oil, and intraocular inflammation.
Results: Visual acuity increased significantly (P=0.011) from preoperatively
0.09 ± 0.28 to 0.11 ± 0.22 postoperatively. Intraocular
pressure did not change significantly (P=0.64) after pars plana vitrectomy
from 12.5 ± 6.6 mm Hg (Median, 12 mm Hg) to 13.0 ± 4.8 mm
Hg (Min.-Max.: 7 - 24 mm Hg; Median, 12 mm Hg). Emulsification of silicone
oil which may have led to a marked elevation of intraocular pressure was
not observed in any patient. In none of the patients, a marked intraocular
inflammation longer than one week after pars plana vitrectomy was observed,
nor was a longer standing bullous keratopathy detected.
Conclusions: As in adult patients, silicone oil may be used in
pediatric and adolescent patients for temporary ocular endotamponade.
The profile and frequency of complications is roughly comparable to that
of adult patients.