Management of retinal redetachment following silicone-oil removal

The aim of the present investigation was to study the clinical course of eyes presenting with retinal redetachment after silicone-oil removal (SOR), with special regard being paid to the long-term visual outcome. Between October 1989 and September 1994, SOR was performed on a consecutive series of 262 eyes that had previously undergone vitrectomy combined with silicone-oil injection for complex retinal detachments. The records of these patients were analyzed retrospectively. The mean follow-up period after redetachment following SOR was 26.3 (range 6-45) months. Redetachment occurred in 35 eyes (13.4%), mostly within 1-3 months of SOR. Redetachment was not dependent on the surgical procedure or the underlying disease. A total of 24 eyes were revitrectomized and a stable flat retina was the result in 23 eyes (65.7%). At the latest follow-up visit, 18 eyes (51.4%) had a visual acuity (VA) of > or = 0.02 and 14 eyes (40%) had a VA of > or = 0.1. In 12 eyes (34.3%) the final VA equalled the best VA recorded before redetachment; an increase in VA occurred in 6 eyes (17.1%) and a deterioration was noted in 17 eyes (48.6%). Only 6 of the 17 eyes that deteriorated had displayed a VA of > or = 0.02 prior to SOR and lost formed vision due to redetachment; these 6 eyes represent 17.1% of the eyes presenting with redetachment after SOR and 2.3% of all 262 eyes that had undergone SOR. These observations demonstrate that revitrectomy is an effective treatment for retinal redetachment after silicone-oil removal. The final failure rate does not appear high enough to justify a contraindication for routine removal of silicone oil, especially since it remains a matter of speculation as to whether these eyes would have fared better had removal of silicone oil been avoided.