1Hugger P., 2Knorr H. L. J., 1Jonas J. B.

1Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, Ruprecht-Karls- University Heidelberg

Purpose: Bullous keratopathy is one among other complications of silicone oil endotamponade in the treatment of proliferative vitreoretinopathy and proliferative diabetic retinopathy. The purpose of the present study was to evaluate the freqency of, and the risk factors for, the development of bullous keratopathy as consequence of corneal endothelial decompensation due to silicone oil endotamponade.
Patients and Methods: The retrospective study included all 225 patients who underwent pars plana vitrectomy with silicone oil endotamponade (5000 centistoke viscosity), in whom silicone oil was removed on an average 10 months after pars plana vitrectomy, and in whom follow-up after oil removal was at least 3 months (mean ± S.D., 17.4 ± 14.4 months). All patients were operated on by one of two surgeons. Outcome measures were corneal transparency as sign of corneal endothelial decompensation, and visual acuity in dependence of the retinal situation.
Results: Corneal decompensation was observed in eight (8/225=3.6%) patients. Its occurrence was associated with the occurrence of a retinal redetachment, silione oil emulsification, elevation of intraocular pressure, and reason for pars plana vitrectomy. Its occurrence was statistically independent of the way to remove silicone oil (transpupillary way versus release through pars plana sclerotomies).
Conclusion: In contrast to the early years of pars plana vitrectomy, bullous keratopathy has become a relatively rare complication of conventional pars plana vitrectomy with silicone oil endotamponade.

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