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      Management and Results of Retinal Detachment after Silicone Oil Removal

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          Abstract

          Of the 168 eyes undergoing silicone oil removal from 1993 to 2000, 34 developed retinal detachment after the removal of silicone oil. The management and the results of the 34 eyes were reviewed. Surgical procedures included pars plana vitrectomy, encircling band, cryocoagulation, endotamponade. Five of the 34 eyes had a second retinal detachment after these operations. One of these 5 eyes had a third retinal detachment. Final retinal reattachment was achieved in all eyes. Visual acuity decreased in 16 of the 34 eyes with retinal detachment, and 18 of the 34 eyes had a visual acuity of less than 0.02. These results show that surgery for retinal detachment after silicone oil removal yields a high rate of anatomic success, while the visual outcome is poor for a substantial number of patients.

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          Retinal redetachment after removal of intraocular silicone oil tamponade.

          To evaluate frequency and risk factors of retinal redetachment after removal of intraocular silicone oil tamponade. The study included 225 patients who consecutively underwent intraocular silicone oil removal at a mean interval of 10 months after pars plana vitrectomy had been performed by one of two surgeons. Mean follow up time was 17.37 (SD 14.40) months (range 3.02-67.42 months). In 57 of 225 (25.3%) patients, the retina detached after removal of silicone oil. Risk factors for retinal redetachment were the following: number of previously unsuccessful retinal detachment surgeries (p=0.0008); surgeon (p=0.007); visual acuity before silicone oil removal (p=0.009); incomplete removal of vitreous base (p=0.01); absence of an encircling band in eyes with proliferate vitreoretinopathy in which an inferior retinotomy had not been performed (p=0.01); and indication for pars plana vitrectomy. Rate of retinal redetachment was statistically (p>0.05) independent of the technique of silicone oil removal and duration of silicone oil endotamponade. Retinal redetachment after removal of silicone oil endotamponade can occur in approximately a fourth of patients, depending on the criteria to use and to remove silicone oil. Risk factors for recurrent detachment included the following: number of previously unsuccessful retinal detachment surgeries, surgeon, preoperative visual acuity, incomplete removal of the vitreous base, absence of an encircling band, and reason for pars plana vitrectomy. The rate of retinal redetachment is independent of the technique of silicone oil removal and duration of silicone oil endotamponade, with a minimal duration of silicone oil tamponade of about 3 months in the present study.
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            Timing of retinal redetachment after removal of intraocular silicone oil tamponade.

            To evaluate the interval between removal of intraocular silicone oil tamponade and retinal redetachment after pars plana vitrectomy, and to investigate factors influencing the length of the interval. The retrospective study included 42 eyes of 42 consecutive patients who experienced a retinal redetachment after silicone oil had been removed 8.0+/-6.2 months after an initial pars plana vitrectomy including intraocular silicone oil (5,000 centistokes) tamponade. Pars plana vitrectomy had been performed for proliferative vitreoretinopathy caused by complicated rhegmatogenous retinal detachment. The retina redetached 2 days to 5.5 months after silicone oil removal (mean +/- SD, 1.3+/-1.4 months; median, 18 days). Thirteen (30%) of all 42 redetachments occurred in the first 9 days, 21 (50%) of all 42 retinal redetachments occurred in the first 18 days, and 32 (75%) of all 42 retinal redetachments occurred in the first 50 days. The interval between silicone oil removal and retinal redetachment was statistically (by analysis of variance) independent of the method of silicone removal (transpupillary drainage vs via pars plana sclerotomies), refractive error of the eye (P = .62), time between initial pars plana vitrectomy and silicone oil removal (P = .99), visual acuity before silicone oil removal (P = .26), type of anesthesia (P = .69), gender (P = .80), and age (P = .48) of the patients. The risk of retinal redetachment decreases steeply with increasing time after silicone oil removal. Three to 5 months after oil removal, retinal redetachment becomes unlikely. The time of retinal redetachment is statistically independent of the method of silicone oil removal, refractive error, time between the preceding pars plana vitrectomy and silicone oil removal, visual acuity before silicone oil removal, type of anesthesia, and gender and age of the patents. These data may be important for scheduling reexaminations and for counseling patients in their planned activities after removal of intraocular silicone oil tamponade.
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              REDUCED RATE OF RETINAL DETACHMENT FOLLOWING SILICONE OIL REMOVAL

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                Author and article information

                Journal
                OPH
                Ophthalmologica
                10.1159/issn.0030-3755
                Ophthalmologica
                S. Karger AG
                0030-3755
                1423-0267
                2002
                October 2002
                08 November 2002
                : 216
                : 5
                : 341-345
                Affiliations
                aDepartment of Ophthalmology and Eye Hospital, University of Saarland, Homburg, Germany, and bDepartment of Ophthalmology, Union Hospital, Tongji Medical College, Hua Zhong University of Science and Technology, Wuhan, China
                Article
                66176 Ophthalmologica 2002;216:341–345
                10.1159/000066176
                12424400
                © 2002 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 2, References: 16, Pages: 5
                Categories
                Original Paper · Travail original · Originalarbeit

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