Removal of silicone oil--rewards and penalties

Silicone oil is a useful tool in retinal reattachment surgery in selected cases, but complications, particularly cataract, glaucoma and keratopathy, have led to worries about its use for prolonged internal tamponade. Removal of silicone oil has been recommended to preempt or reverse these complications. A retrospective review of 120 eyes in which temporary silicone oil tamponade had been employed is presented. One hundred and twelve eyes were examined six months and two years after removal of silicone oil. Retinal redetachment occurred in 21 eyes (19%). Cataract formation was delayed by early removal of silicone oil, but after two years the majority of eyes had undergone surgery for cataract or had developed lens opacities. Removal of silicone oil was ineffective in reversing an established pressure rise in nearly all cases. Three phakic eyes developed glaucoma after removal of silicone oil but no new cases occurred in phakic eyes in the two years following silicone oil removal. Keratopathy was uncommon and was arrested and occasionally reversed by silicone oil removal. Visual acuities improved in the majority of eyes after removal of silicone oil.