Combined removal of silicone oil plus internal search (ROSO-plus) following retinal detachment surgery

To report the rate of retinal redetachment and intervention with combined removal of silicone oil plus internal search (ROSO-plus) and to report the pathology identified.

Preoperative and peroperative findings were related to postoperative failure of the surgery defined as retinal redetachment postoperatively or silicone oil in situ at the final follow-up.

Sixty-three patients were included in the study. Mean follow-up was 13 months. Retinopexy and further tamponade were used in 22 patients. Overall 'ROSO-plus' failed in 13 (21%) patients. Patients with subretinal fluid (SRF) in the inferior quadrants of the fundus during 'ROSO-plus' were particularly at risk of failure at 86% (six of seven patients) vs 12.5% (7/56) for the remainder (P=0.0002, relative risk=6.9, 95% confidence interval 3.2-14.6). The overall success rate at final follow-up (after any further surgery) for a flat retina without oil in situ was 83%.

The 'ROSO-plus' procedure allowed identification of problems expected to result in anatomical failure. Treatment did not prevent a high rate of postoperative retinal detachment. Refinement of the treatment algorithm is required with perhaps more use of silicone oil reinsertion in high-risk eyes.