Silicone oil for progressive anterior ocular neovascularization after failed diabetic vitrectomy

We have performed revision of vitrectomy and silicone oil injection in 18 eyes that developed advanced iris neovascularization and/or anterior hyaloidal fibrovascular proliferation complicated by retinal detachment or media opacity after vitreous surgery for the complications of proliferative diabetic retinopathy. Stabilization or regression of the anterior ocular neovascular changes was noted in 83% of the eyes. Sustained retinal attachment was achieved in 56% of the eyes, with visual acuity improving to 20/400 or better in 28% of the eyes. Posterior segment vascular and avascular reproliferation was the major cause of anatomic failure, while generalized retinal vascular ischemia was felt to be the principal cause of poor visual results despite retinal attachment. Revision of vitrectomy with silicone oil injection is of limited value in the management of complicated and advanced anterior ocular neovascularization after unsuccessful vitrectomy for diabetic retinopathy.