Outcomes After Silicone Oil Removal in Patients with Acute Retinal Necrosis Who Underwent Vitrectomy

To investigate the outcomes after silicone oil removal (SOR) in patients with acute retinal necrosis (ARN).

Retrospective case series. Patients diagnosed with ARN-associated retinal detachment (RD) who underwent vitrectomy and silicone oil tamponade and subsequent SOR between January 2013 and December 2021 who were followed up for ≥1 year after SOR were included. The medical records before and after SOR were reviewed.

Fifty-three eyes from 52 patients were included. SOR was conducted at 201.3 ± 104.1 days (range, 63‒547) after vitrectomy. The duration of follow-up after SOR was 1266.8 ± 797.2 days (range, 384-3865). The logMAR BCVA before SOR, at 1 year after SOR, and at the last follow-up were 1.249 ± 0.816, 1.086 ± 0.791, and 1.488 ± 0.961. The intraocular pressure (IOP) at the corresponding times were 13.2 ± 3.6, 10.9 ± 3.4, and 10.4 ± 3.5 mmHg. Seven patients (13.5%) experienced recurrent RD at 81.0 ± 46.7 days (range, 18‒154) after SOR. At 1 year after SOR, 4 eyes (7.5%) had hypotony and 26 (49.1%) had macular edema; the corresponding numbers were 7 (13.5%) and 27 (51.9%) at the last follow-up. The IOP at the time of SOR (r =  -0.438, p = 0.001) was the risk factor for the occurrence of hypotony after SOR (area under the ROC curve: 0.873; cutoff value: 11.30 mmHg).

The BCVA and IOP continued to change after SOR in ARN patients. Ocular complications mostly occurred within the first year after SOR. IOP at the time of SOR was a main predictor of the clinical outcomes after SOR.