Silicone oil tamponade for retinal detachment and delayed treatment of retinal tears

Four patients underwent a vitrectomy procedure for retinal detachment associated with anterior and posterior proliferative vitreoretinopathy (D-1 type). In each patient, an internal tamponade was achieved with 1000-centistoke silicone oil. Preretinal and/or subretinal hemorrhage that was difficult to remove during surgery, as well as remnants of subretinal fluid, prevented complete intraoperative treatment of the retinal tears or the retinotomy with endolaser photocoagulation. The silicone oil tamponade kept the retina flat until laser treatment was applied to the retinal tears several weeks later, when the retinal blood and subretinal fluid had reabsorbed. When circumstances make achieving intraoperative laser marks difficult, silicone oil tamponade appears to be superior to a long-lasting gas tamponade. It provides a more permanent tamponade than gas and excellent visualization of the fundus several weeks after surgery, at which time laser marks can be completed.