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Silicone oil in the repair of pediatric complex retinal detachments: a prospective, observational, multicenter study.
Ophthalmology. 1999 Jul; 106(7):1399-407; discussion 1407-8.O

Abstract

OBJECTIVE

To report anatomic and visual acuity outcomes, as well as complications, after using 1000-centistoke silicone oil as a retinal tamponade for the treatment of complex retinal detachments in a pediatric population.

DESIGN

A prospective, observational, multicenter study.

PARTICIPANTS

The study cohort consisted of 205 patients 16 years of age or younger (211 eyes) treated at community and university-based ophthalmology clinics for complex retinal detachments associated with trauma, proliferative vitreoretinopathy (PVR), giant retinal tear (GRT), or retinopathy of prematurity (ROP).

INTERVENTION

Vitrectomy surgery for complex retinal detachment with 1000-centistoke silicone oil as the retinal tamponade.

MAIN OUTCOME MEASURES

Anatomic outcomes include complete retinal attachment and macular attachment. Visual acuity outcomes include ambulatory vision (> or = 4/200) and preservation of preoperative visual acuity. Complications include rates of secondary intraocular pressure (IOP) elevation (> or = 30 mmHg), hypotony (< or = 5 mmHg), corneal opacification (including band keratopathy, corneal edema, and corneal abrasions), oil emulsification, and cataract. All outcome measures were assessed 6, 12, and 24 months after surgery and at last examination.

RESULTS

At the 6-month examination, the retina was completely attached in 43 (57%) of 76 eyes in the trauma group, 24 (63%) of 38 PVR eyes, 23 (68%) of 34 GRT eyes, and 6 (33%) of 18 ROP eyes. The macula was attached in 60 (79%), 33 (87%), 26 (76%), and 8 (44%) eyes, respectively. Ambulatory vision was achieved in 19 (25%) eyes in the trauma group, 18 (47%) PVR eyes, 19 (56%) GRT eyes, and 4 (22%) ROP eyes. Visual acuity was preserved in 53 (70%), 26 (68%), 28 (82%), and 9 (50%) eyes, respectively. The corresponding rates of complications for traumatic, PVR, GRT, and ROP eyes were: elevated IOP-3 (4%) of 76, 1 (3%) of 38, 1 (3%) of 34, and 0 (0%) of 18; hypotony--9 (12%), 3 (8%), 2 (6%), and 2 (11%); corneal opacity--25 (33%), 8 (21%), 15 (44%), and 5 (28%); emulsification--4 (5%), 1 (3%), 3 (9%), and 1 (6%); and cataract in phakic eyes--1 (33%) of 3, 2 (67%) of 3, 2 (50%) of 4, and 1 (33%) of 3.

CONCLUSIONS

Retinal reattachment and preserved visual acuity were achieved in the majority of eyes using vitrectomy and silicone oil retinal tamponade. Complete retinal and macular attachment was achieved less frequently in ROP eyes than in eyes in the other diagnostic groups. Use of 1000-centistoke silicone oil can be considered in the management of pediatric complex retinal detachments associated with multiple etiologies.

Authors+Show Affiliations

Scott IU
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Florida 33136, USA.
Flynn HW
No affiliation info available
Azen SP
No affiliation info available
Lai MY
No affiliation info available
Schwartz S
No affiliation info available
Trese MT
No affiliation info available

MeSH

AdolescentChildEye InjuriesFemaleHumansInfant, NewbornIntraocular PressureMaleObservationProspective StudiesRetinal DetachmentRetinal PerforationsRetinopathy of PrematuritySilicone OilsTreatment OutcomeVisual AcuityVitrectomyVitreoretinopathy, Proliferative

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10406629

Citation

Scott, I U., et al. "Silicone Oil in the Repair of Pediatric Complex Retinal Detachments: a Prospective, Observational, Multicenter Study." Ophthalmology, vol. 106, no. 7, 1999, pp. 1399-407; discussion 1407-8.
Scott IU, Flynn HW, Azen SP, et al. Silicone oil in the repair of pediatric complex retinal detachments: a prospective, observational, multicenter study. Ophthalmology. 1999;106(7):1399-407; discussion 1407-8.
Scott, I. U., Flynn, H. W., Azen, S. P., Lai, M. Y., Schwartz, S., & Trese, M. T. (1999). Silicone oil in the repair of pediatric complex retinal detachments: a prospective, observational, multicenter study. Ophthalmology, 106(7), 1399-407; discussion 1407-8.
Scott IU, et al. Silicone Oil in the Repair of Pediatric Complex Retinal Detachments: a Prospective, Observational, Multicenter Study. Ophthalmology. 1999;106(7):1399-407; discussion 1407-8. PubMed PMID: 10406629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Silicone oil in the repair of pediatric complex retinal detachments: a prospective, observational, multicenter study. AU - Scott,I U, AU - Flynn,H W,Jr AU - Azen,S P, AU - Lai,M Y, AU - Schwartz,S, AU - Trese,M T, PY - 1999/7/16/pubmed PY - 2001/3/28/medline PY - 1999/7/16/entrez SP - 1399-407; discussion 1407-8 JF - Ophthalmology JO - Ophthalmology VL - 106 IS - 7 N2 - OBJECTIVE: To report anatomic and visual acuity outcomes, as well as complications, after using 1000-centistoke silicone oil as a retinal tamponade for the treatment of complex retinal detachments in a pediatric population. DESIGN: A prospective, observational, multicenter study. PARTICIPANTS: The study cohort consisted of 205 patients 16 years of age or younger (211 eyes) treated at community and university-based ophthalmology clinics for complex retinal detachments associated with trauma, proliferative vitreoretinopathy (PVR), giant retinal tear (GRT), or retinopathy of prematurity (ROP). INTERVENTION: Vitrectomy surgery for complex retinal detachment with 1000-centistoke silicone oil as the retinal tamponade. MAIN OUTCOME MEASURES: Anatomic outcomes include complete retinal attachment and macular attachment. Visual acuity outcomes include ambulatory vision (> or = 4/200) and preservation of preoperative visual acuity. Complications include rates of secondary intraocular pressure (IOP) elevation (> or = 30 mmHg), hypotony (< or = 5 mmHg), corneal opacification (including band keratopathy, corneal edema, and corneal abrasions), oil emulsification, and cataract. All outcome measures were assessed 6, 12, and 24 months after surgery and at last examination. RESULTS: At the 6-month examination, the retina was completely attached in 43 (57%) of 76 eyes in the trauma group, 24 (63%) of 38 PVR eyes, 23 (68%) of 34 GRT eyes, and 6 (33%) of 18 ROP eyes. The macula was attached in 60 (79%), 33 (87%), 26 (76%), and 8 (44%) eyes, respectively. Ambulatory vision was achieved in 19 (25%) eyes in the trauma group, 18 (47%) PVR eyes, 19 (56%) GRT eyes, and 4 (22%) ROP eyes. Visual acuity was preserved in 53 (70%), 26 (68%), 28 (82%), and 9 (50%) eyes, respectively. The corresponding rates of complications for traumatic, PVR, GRT, and ROP eyes were: elevated IOP-3 (4%) of 76, 1 (3%) of 38, 1 (3%) of 34, and 0 (0%) of 18; hypotony--9 (12%), 3 (8%), 2 (6%), and 2 (11%); corneal opacity--25 (33%), 8 (21%), 15 (44%), and 5 (28%); emulsification--4 (5%), 1 (3%), 3 (9%), and 1 (6%); and cataract in phakic eyes--1 (33%) of 3, 2 (67%) of 3, 2 (50%) of 4, and 1 (33%) of 3. CONCLUSIONS: Retinal reattachment and preserved visual acuity were achieved in the majority of eyes using vitrectomy and silicone oil retinal tamponade. Complete retinal and macular attachment was achieved less frequently in ROP eyes than in eyes in the other diagnostic groups. Use of 1000-centistoke silicone oil can be considered in the management of pediatric complex retinal detachments associated with multiple etiologies. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/10406629/Silicone_oil_in_the_repair_of_pediatric_complex_retinal_detachments:_a_prospective_observational_multicenter_study_ DB - PRIME DP - Unbound Medicine ER -