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Impressum
Jiang F. G., Krause M., Hille K., Spang S., Ruprecht K. W.
Department of Ophthalmology, University of Saarland, Homburg, Germany
Objective: To evaluate the impact of silicone oil removal (SOR)
on visual acuity (VA), anatomic results, and complications.
Methods: The retrospective study included 94 eyes of 92 consecutive
patients presenting in our hospital between 1996 and 2000. All patients
had SOR after previous vitreoretinal surgery with silicone oil. A complete
ocular examination was performed, including best-corrected VA, measurement
of intraocular pressure, slitlamp examination, and binocular indirect
ophthalmoscopy before and at different time points after SOR. Average
follow-up was 24.5 months.
Results: Seventy eyes (74%) had a final VA >/= 0.02. The VA
increased in 52/94 eyes (55%) and decreased in 30/94 eyes (32%), when
compared with VA before SOR. The number of eyes with increased VA was
significantly higher than the number with decreased VA (p<0.01). Final
anatomic success was achived in 93/94 eyes (99%), while one eye had to
be enucleated. Nineteen of 94 eyes (20%) had recurrent retinal detachments
(RD) after SOR. The VA of these eyes increased in 5/19 eyes (26%) and
decreased in 11/19 eyes (58%). The number of eyes with decreased VA was
significantly higher than the number with increased VA (p<0.01). In
all 19 eyes with recurrent RD, final reattachment was achieved by additional
surgeries. The incidence of hypertony and keratopathy before SOR was 59%
and 27%. After SOR, the incidence dropped to 18% and 6%, respectively.
All decreases were significant (p<0.01). In contrast, the incidence
of hypotony increased by a factor of 2.3 (p<0.01).
Conclusion: Improved VA was found in the majority of eyes. The
rate of final anatomic success was very high. After SOR, the incidence
of hypertony and keratopathy was reduced. However, SOR was followed by
a substantial rate of recurrent detachments with an overall decrease of
VA. SOR may need careful consideration on an individual base.