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Silicone oil in the repair of complex retinal detachments. A prospective observational multicenter study.
Ophthalmology. 1998 Sep; 105(9):1587-97.O

Abstract

OBJECTIVE

This study aimed to report anatomic and visual acuity outcomes and complications after 1000-centistoke silicone oil was used as a retinal tamponade for the treatment of complex retinal detachments.

DESIGN

Prospective observational multicenter study conducted at community and university-based ophthalmology clinics.

PARTICIPANTS

The study cohort consisted of 2439 patients (2573 eyes) treated for complex retinal detachments associated with cytomegalovirus (CMV) necrotizing retinitis or a non-CMV etiology, including proliferative diabetic retinopathy, giant retinal tears, proliferative vitreoretinopathy, or ocular trauma.

INTERVENTION

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

MAIN OUTCOME MEASURES

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

RESULTS

At the 6-month examination, the retina was completely attached in 178 (78%) of 228 CMV eyes and in 855 (70%) of 1219 non-CMV eyes. The macula was attached in 216 (95%) of 228 and 1062 (89%) of 1189 CMV and non-CMV eyes, respectively. Ambulatory vision was noted in 151 (65%) of 234 CMV eyes and in 480 (38%) of 1251 non-CMV eyes. Visual acuity was preserved in 106 (46%) of 230 and 1035 (84%) of 1229 CMV and non-CMV eyes, respectively. The corresponding rates of complications for CMV and non-CMV eyes were: elevated intraocular pressure, 0 (0%) of 196 and 35 (3%) of 1196; hypotony, 11 (6%) of 196 and 228 (19%) of 1196; corneal opacity, 13 (6%) of 229 and 326 (26%) of 1248; emulsification, 3 (1%) of 211 and 29 (3%) of 959; and cataract in phakic eyes, 118 (64%) of 185 and 50 (63%) of 80.

CONCLUSIONS

Retinal reattachment was achieved in the majority of eyes using vitrectomy and silicone oil retinal tamponade. Complication rates generally were less frequent in CMV eyes, but follow-up was shorter in this group of patients, largely because of reduced life expectancy. Cataract frequently developed in phakic eyes of study patients. Use of 1000-centistoke silicone oil can be considered in the management of complex retinal detachments associated with multiple etiologies.

Authors+Show Affiliations

Azen SP
Department of Preventive Medicine, University of Southern California, Los Angeles 90033, USA.
Scott IU
No affiliation info available
Flynn HW
No affiliation info available
Lai MY
No affiliation info available
Topping TM
No affiliation info available
Benati L
No affiliation info available
Trask DK
No affiliation info available
Rogus LA
No affiliation info available

MeSH

AdultCohort StudiesCytomegalovirus RetinitisEye InjuriesFemaleHumansIntraocular PressureMaleMiddle AgedProspective StudiesRetinal DetachmentRetinal DiseasesSilicone OilsTreatment OutcomeVisual AcuityVitrectomy

Pub Type(s)

Clinical Trial
Controlled 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

9754162

Citation

Azen, S P., et al. "Silicone Oil in the Repair of Complex Retinal Detachments. a Prospective Observational Multicenter Study." Ophthalmology, vol. 105, no. 9, 1998, pp. 1587-97.
Azen SP, Scott IU, Flynn HW, et al. Silicone oil in the repair of complex retinal detachments. A prospective observational multicenter study. Ophthalmology. 1998;105(9):1587-97.
Azen, S. P., Scott, I. U., Flynn, H. W., Lai, M. Y., Topping, T. M., Benati, L., Trask, D. K., & Rogus, L. A. (1998). Silicone oil in the repair of complex retinal detachments. A prospective observational multicenter study. Ophthalmology, 105(9), 1587-97.
Azen SP, et al. Silicone Oil in the Repair of Complex Retinal Detachments. a Prospective Observational Multicenter Study. Ophthalmology. 1998;105(9):1587-97. PubMed PMID: 9754162.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Silicone oil in the repair of complex retinal detachments. A prospective observational multicenter study. AU - Azen,S P, AU - Scott,I U, AU - Flynn,H W,Jr AU - Lai,M Y, AU - Topping,T M, AU - Benati,L, AU - Trask,D K, AU - Rogus,L A, PY - 1998/10/1/pubmed PY - 2001/3/28/medline PY - 1998/10/1/entrez SP - 1587 EP - 97 JF - Ophthalmology JO - Ophthalmology VL - 105 IS - 9 N2 - OBJECTIVE: This study aimed to report anatomic and visual acuity outcomes and complications after 1000-centistoke silicone oil was used as a retinal tamponade for the treatment of complex retinal detachments. DESIGN: Prospective observational multicenter study conducted at community and university-based ophthalmology clinics. PARTICIPANTS: The study cohort consisted of 2439 patients (2573 eyes) treated for complex retinal detachments associated with cytomegalovirus (CMV) necrotizing retinitis or a non-CMV etiology, including proliferative diabetic retinopathy, giant retinal tears, proliferative vitreoretinopathy, or ocular trauma. INTERVENTION: Vitrectomy surgery was performed for complex retinal detachment with 1000-centistoke silicone oil as the retinal tamponade. MAIN OUTCOME MEASURES: Anatomic outcomes were complete retinal attachment and macular attachment. Visual acuity outcomes were ambulatory vision (> or = 4/200) and preservation of preoperative visual acuity. Complications were rates of secondary intraocular pressure elevation (> or = 30 mmHg), hypotony (< or = 5 mmHg), corneal opacification (including band keratopathy, corneal edema, and corneal abrasions), oil emulsification, and cataract. Outcomes were assessed 6, 12, and 24 months after surgery. RESULTS: At the 6-month examination, the retina was completely attached in 178 (78%) of 228 CMV eyes and in 855 (70%) of 1219 non-CMV eyes. The macula was attached in 216 (95%) of 228 and 1062 (89%) of 1189 CMV and non-CMV eyes, respectively. Ambulatory vision was noted in 151 (65%) of 234 CMV eyes and in 480 (38%) of 1251 non-CMV eyes. Visual acuity was preserved in 106 (46%) of 230 and 1035 (84%) of 1229 CMV and non-CMV eyes, respectively. The corresponding rates of complications for CMV and non-CMV eyes were: elevated intraocular pressure, 0 (0%) of 196 and 35 (3%) of 1196; hypotony, 11 (6%) of 196 and 228 (19%) of 1196; corneal opacity, 13 (6%) of 229 and 326 (26%) of 1248; emulsification, 3 (1%) of 211 and 29 (3%) of 959; and cataract in phakic eyes, 118 (64%) of 185 and 50 (63%) of 80. CONCLUSIONS: Retinal reattachment was achieved in the majority of eyes using vitrectomy and silicone oil retinal tamponade. Complication rates generally were less frequent in CMV eyes, but follow-up was shorter in this group of patients, largely because of reduced life expectancy. Cataract frequently developed in phakic eyes of study patients. Use of 1000-centistoke silicone oil can be considered in the management of complex retinal detachments associated with multiple etiologies. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/9754162/Silicone_oil_in_the_repair_of_complex_retinal_detachments__A_prospective_observational_multicenter_study_ DB - PRIME DP - Unbound Medicine ER -