Surgical outcomes and incidence of retinal redetachment in cases with complicated retinal detachment after silicone oil removal: univariate and multiple risk factors analysis.

PURPOSE: To analyze the surgical outcomes and retinal redetachment frequency after silicone oil (SO) removal for complex retinal detachment. METHODS: This institutional-based study included 894 consecutive patients who underwent pars plana vitrectomy with SO endotamponade for complicated retinal detachment. The effects of preoperative best-corrected visual acuity, vitreous base shaving, intraoperative scleral buckling, retinectomy, SO viscosity, duration of SO, and vitreous hemorrhage at the first postoperative week on the risk of redetachment were investigated. RESULTS: During a mean follow-up of 39.9 months, anatomical success was not achieved in 118 patients (13.2%) after SO removal. On multivariate analysis, risk factors for recurrent retinal detachment included giant retinal tear (adjusted odds ratio [aOR], 12.39; P < 0.001), high myopia (aOR, 2.70; P = 0.011), surgeries without scleral buckling (aOR, 1.97; P = 0.039), inadequate vitreous base shaving (aOR, 117.62; P < 0.001), and vitreous hemorrhage at the first postoperative week (aOR, 12.13; P < 0.001). CONCLUSION: Retinal detachment etiology, inadequate vitreous base shaving, lack of intraoperative scleral buckling, and vitreous hemorrhage at the first postoperative week after SO removal were significant risk factors for retinal redetachment after SO removal, but preoperative visual acuity, SO viscosity, and duration of SO had no significant effect on redetachment.

Intravitreal silicone oil induced changes in corneal biomechanics.

Our aim was to detect the early effects of pars plana vitrectomy (PPV) combined with intravitreal silicone oil (SO) on corneal biomechanics. 19 eyes underwent PPV with SO tamponade (group 1) and 16 eyes underwent. PPV without tamponade (group 2). Corneal biomechanical parameters were measured preoperatively and at the first postoperative month by ocular response analyzer. The mean preoperative intraocular pressure (IOP) by Goldmann applanation tonometry (GAT) and the mean corneal-compensated intraocular pressure (IOPcc) were significantly lower in group 1 than group 2 (p = 0.005, p = 0.002, respectively). The mean preoperative corneal hysteresis (CH) and corneal resistance factor (CRF) were significantly higher in group 1 than group 2 (p = 0.017, p = 0.002, respectively). However, the difference in Goldmann-correlated intraocular pressure (IOPg) between the groups was not significant (p = 0.360). In group 1, IOPcc, IOPg and IOP-GAT significantly increased postoperatively (p = 0.002, p = 0.004, p = 0.002, respectively) but CH and CRF decreased (p = 0.007, p = 0.153, respectively). In group 2, IOPcc, IOPg and IOP (GAT) increased postoperatively but the differences were not significant (p = 0.851, p = 0.693, p = 0.336, respectively). The mean CRF increased significantly (p = 0.026) postoperatively but the decrease in CH was not significant (p = 0.196). Statistically significant differences were found in the changes of preoperative and postoperative means of IOPcc, IOPg, IOP-GAT and CRF between the groups (p = 0.024, p = 0.037, p = 0.014, p = 0.006, respectively). However, the difference in the decreases in CH between the two groups was not statistically significant (p = 0.206). SO tamponade may affect corneal biomechanical parameters in the early postoperative period, which may be related to the surgery itself, SO tamponade or IOP changes.

Nonsurgical management of an intraorbital pencil without cranial or globe penetration.

A 3-year-old boy suffered a penetrating orbital pencil injury in the right upper eyelid. Examination showed no signs of globe perforation, fractures, or neurologic deficits. The pencil was removed with controlled and slow motion. Visual acuity was 20/20 and anterior and posterior segment findings were normal 2 months after the injury.