Risk factors for anatomical success and visual outcome in patients undergoing silicone oil removal

To define risk factors for anatomical success and visual outcome in patients undergoing removal of silicone oil.

This retrospective study included patients who had silicone oil removed at this hospital between 1996 and 2000. All were followed for at least six months. Patients with recurrent retinal detachment after silicone oil removal were compared with patients without this complication. We also compared patients whose vision improved or stabilized with patients whose vision deteriorated. Risk factors for anatomical success and visual outcome were identified.

We analysed 94 eyes of 92 patients with silicone oil removal. Nineteen eyes (20%) had recurrent retinal detachment, and in 30 eyes (32%), the vision deteriorated after removal of the oil. Initial vision less than ambulatory vision, initial pathology of giant retinal tears and recurrent retinal detachment, postoperative hypotony and postoperative epiretinal membrane occurred more frequently in eyes with than without recurrent retinal detachment. Pre- and postoperative hypotony, postoperative epiretinal membranes and postoperative recurrent retinal detachment were also more frequent in eyes with deteriorated vision.

When treating giant retinal tears or recurrent retinal detachments with silicone oil tamponade, surgeons and their patients need to be aware of the higher possibility of unfavorable results, particularly when the initial vision is less than ambulatory vision. The presence of risk factors before and after silicone oil removal should remind surgeons of the higher risk profile of this particular surgery.