Comparison of fundus changes following silicone oil and sterilized air tamponade for macular-on retinal detachment patients

Microstructural and hemodynamic changes in the fundus after pars plana vitrectomy for different vitreoretinal diseases

BACKGROUND

Pars plana vitrectomy is the standard treatment for several vitreoretinal diseases. Continuous improvements in ophthalmic surgical techniques have led to excellent postoperative recovery of the anatomic structure of the fundus. However, postoperative visual outcomes are not always satisfactory.

METHODS

A literature search of articles published before 31 December 2022 was conducted on PubMed using the following keywords: "diabetic retinopathy," "rhegmatogenous retinal detachment," "idiopathic epiretinal membrane," "idiopathic macular hole," "vitrectomy," "optical coherence tomography," "optical coherence tomography angiography," "microstructure," "microstructural," "hemodynamic," "hemodynamics," and "microcirculation." Additional studies were identified by hand-searching references for relevant studies. Articles were screened for language, repetition, and relevance to the direction of study. Studies with a sample size ≥ 7 and the final follow-up time ≥ 4 weeks after vitrectomy were included in this review. Only articles published in English were included. Articles not related to our topic were excluded. Reviews and single case reports were excluded. We structured this review by disease category. The thickness of the retina and choroid, the area of the foveal avascular zone, the vessel density of the retinal and choroidal capillary plexus, and the potential association of related parameters with postoperative visual outcomes are the main outcome measures of studies included in this review.

RESULTS

A total of 48 studies were included in this review. There were contradictory results regarding the association between postoperative microcirculatory parameters and visual acuity in patients with diabetic macular edema, with some studies concluding that improvement in perimacular microcirculation may be an important factor that affects visual acuity, and others concluded that postoperative improvement in visual acuity was not related to changes in macular blood flow. The results of studies on the relationship between postoperative microstructural and microcirculatory parameters and visual acuity in rhegmatogenous retinal detachment, idiopathic epiretinal membrane, and idiopathic macular hole eyes have been inconsistent. In gas tamponade macula-off rhegmatogenous retinal detachment eyes, postoperative best-corrected visual acuity has been reported to correlate positively with vessel density of deep capillary plexus and negatively with foveal avascular zone area of superficial capillary plexus and deep capillary plexus. In silicone oil tamponade macula-off rhegmatogenous retinal detachment eyes, best-corrected visual acuity has been reported to be positively correlated with the retinal thickness of the parafoveal 3 mm temporal quadrant and positively correlated with the vessel density of the superficial capillary plexus in the foveal, parafoveal, and perifoveal area. In addition, best-corrected visual acuity was worse and associated with reduced thickness of the inner retina, ganglion cell layer, outer plexiform layer, and outer nuclear layer in silicone oil tamponade rhegmatogenous retinal detachment eyes compared to gas tamponade. Postoperative best-corrected visual acuity in idiopathic epiretinal membrane eyes was positively correlated with the foveal avascular zone area but negatively correlated with full retinal thickness and inner retinal thickness in the foveal and parafoveal areas. Improvement in postoperative best-corrected visual acuity in idiopathic macular hole eyes was associated with reduced inner retinal thickness and reduced foveal avascular zone area.

CONCLUSIONS

Microstructural and hemodynamic changes are involved in the recovery process after PPV for different vitreoretinal diseases. The thickness of each retinal layer in different regions of the macula, foveal avascular zone area, and vessel density of different retinal capillary plexuses in different macular regions may be potential prognostic factors for postoperative visual recovery. However, the results of the existing literature are inconsistent and require further study.

Pars Plana Vitrectomy With Silicone Oil or Gas Tamponade for Uncomplicated Retinal Detachment: A Systematic Review and Meta-Analysis

PURPOSE

To compare the efficacy and safety of pars plana vitrectomy (PPV) with silicone oil compared to gas tamponade for uncomplicated rhegmatogenous retinal detachment (RRD).

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Library from January 2000 to September 2023 for comparative studies evaluating the efficacy and safety of PPV with either silicone oil or gas tamponade in the setting of uncomplicated RRD. Our primary outcome was best-corrected visual acuity at the last study observation. Secondary outcomes included the rates of retinal reattachment, retinal thickness, and the incidence of adverse events. We performed a meta-analysis using a random-effects model.

RESULTS

Nine observational studies reporting on 491 RRD eyes were included. The mean best-corrected visual acuity at the last study observation was significantly better in the gas tamponade group than in the silicone oil group (weighted mean difference [WMD] = 0.17 logMAR, 95% confidence interval [CI] = [0.06, 0.27], P = .002). Rates of primary retinal reattachment were similar between the silicone oil and gas tamponade groups (P = .89). The ganglion cell layer was significantly thinner in the silicone oil group compared to the gas tamponade group (WMD =-3.70 µm, 95% CI = [-5.87, -1.53, P = .0008), as was the inner plexiform layer (WMD = -2.45, 95% CI = [-4.50, -0.40], P = .02) and outer nuclear layer (WMD = -11.74 µm, 95% CI = [-18.39, -5.10], P = .0005).

CONCLUSIONS

PPV with gas tamponade was associated with better functional outcomes compared to PPV with silicone oil, although both tamponades yielded comparable primary reattachment rates. The absence of randomized trials and the potential for selection bias underscore the importance of further investigation in diverse patient populations.

Impact of duration of silicone oil tamponade on foveal and parafoveal thickness in rhegmatogenous retinal detachment: a retrospective cohort study

PURPOSE

To detect and analyze the influence of the duration of tamponade with silicone oil on the foveal and parafoveal thickness in cases of rhegmatogenous retinal detachment.

METHODS

This is a retrospective cohort study of 64 eyes with rhegmatogenous retinal detachment in one eye who underwent pars plana vitrectomy (PPV) with silicone oil injection during the period between January 2019 and December 2021. The patients were divided into 2 groups. Group A with early removal of the silicone oil after 3-4 months and Group B with late removal of the silicone oil (SOR) after 6-8 months. The 2 groups were compared as regards the central foveal (CFT) and parafoveal (PFT) thickness changes from baseline, just before SOR, and after SOR. Changes in best corrected visual acuity (BCVA), relative risk of severe thinning. It was conducted at Kasr Alainy Hospital.

RESULTS

64 eyes were enrolled in the study. Group A included 36 eyes, and group B included 28 eyes. The mean CFT changed insignificantly from 253 ± 52 μm to 252 ± 48 μm after SOR in group A; while it changed significantly from 211 ± 52 μm to 202 ± 46 μm after SOR in group B. The mean PFT decreased insignificantly from 299 ± 39 μm to 297 ± 40 μm in group A, while it decreased significantly from 284 ± 46 μm to 273 ± 44 μm in group B. Lines of improvement of BCVA were 4.11 ± 1.88 in group A, and 2.00 ± 1.24 in group B. Relative risk of severe foveal thinning after SOR was 14.3, and severe parafoveal thinning was 15.43, in group B compared to group A.

CONCLUSION

Longer period of silicone oil tamponade may carry a higher risk for severe foveal and parafoveal thinning after silicone oil removal.

TRIAL REGISTRATION

The study was registered at clinical trial.gov under the title of (Duration of silicone oil tamponade on foveal and parafoveal thickness in Rhegmatogenous Retinal Detachment) with an ID NCT05817630 at April 2023 "retrospectively registered".

Effect of silicone oil versus gas tamponade on macular layer microstructure after pars plana vitrectomy for macula on rhegmatogenous retinal detachment

PURPOSE

To analyze structural changes in the macular retinal layers and sub-foveal choroidal thickness (SFCT) in eyes after macula-on rhegmatogenous retinal detachment (RRD) repair by pars plana vitrectomy with either silicone oil (SO) or gas tamponade, and the effect of these changes on visual acuity.

PATIENTS AND METHODS

Retrospective study which included 26 eyes in the SO Group and 32 in the Gas Group. Optical coherence tomography (OCT) scans of the affected eyes were obtained before surgery, and 3 months after PPV in the Gas Group, and during silicone oil in situ and 3 months after SO removal, in the SO Group. Qualitative assessment of photoreceptor layer and foveal contour, along with quantitative assessment of macular retinal thickness and SFCT was performed. Postoperative OCT macular microstructural changes were recorded and correlated to corrected distance visual acuity (CDVA). Intraocular pressure (IOP) was measured preoperative and at 3 months post operative.

RESULTS

There was a 2-line loss (from 20/28 preoperatively to 20/40 at final follow-up) of CDVA in the SO Group (p=0.051), while there was no statistically significant change in CDVA in the Gas Group (p=0.786). There was no significant correlation between CDVA loss and duration of silicon tamponade (r=-0.031, p=0.893). There was a statistically significant increase in IOP from its baseline to final follow-up of 0.7 mmHg in the SO Group (p=0.023) while there was no statistically significant change in IOP in the Gas Group. During silicone oil tamponade, there was approximately 11% and 5% of retinal and sub-foveal choroidal thinning respectively, which was moderately resolved following silicone oil removal. 20% (5/24) of eyes in the SO Group had qualitative flattening of foveal contour during SO tamponade that resolved after SO removal.

CONCLUSION

Thinning of the macula was noticed after macula-on RRD repair with SO tamponade. Such thinning was only partially reversible after the removal of SO.

Microvascular changes after pars plana vitrectomy for rhegmatogenous retinal detachment repair: A comparative study based on gas tamponade agent

PURPOSE

The purpose of this study was to investigate the effect of gas tamponade on microvascular changes in patients with rhegmatogenous retinal detachment (RRD), who underwent pars plana vitrectomy (PPV), using optical coherence tomography angiography (OCTA).

METHODS

Participants in this study were 48 patients with RRD, who were treated with PPV and gas tamponade without internal limiting membrane peeling. All participants underwent slit-lamp examination, fundoscopy, spectral domain-optical coherence tomography and optical coherence tomography angiography at month 6 postoperatively. The fellow untreated eyes were also examined and served as the control data.

RESULTS

A statistically significant enlargement in the foveal avascular zone (FAZ) in both the superficial (p = 0.002) and the deep capillary plexus (p = 0.01) was noticed 6 months postoperatively in patients with RRD treated with PPV compared to the fellow eyes. The foveal avascular zone perimeter was increased in the operated eyes in the deep capillary plexus (p = 0.0003) and the foveal avascular zone circularity was decreased in both the superficial (p = 0.045) and the deep capillary plexus (p < 0.001) compared to the fellow eyes. The vessel density was not significantly different between the operated and the fellow eyes in the superficial and the deep capillary plexus. The vessel density and the foveal avascular zone parameters were comparable between the C3F8 and SF6 groups.

CONCLUSION

Specific microvascular indices as measured by OCTA were statistically different between the operated and the fellow eyes in the superficial and deep capillary plexus. C3F8 and SF6 as gas tamponades did not seem to differ in their impact on the microvascular parameters.

Choroidal vascular changes in silicone oil-filled eyes after vitrectomy for rhegmatogenous retinal detachments

INTRODUCTION

The tamponade of silicone oil (SO) can affect both the structure and blood flow of the retina. However, there are few studies on the effect of SO tamponade on choroidal blood flow. Our study aimed to compare the effects of SO tamponade on the choroidal vascular index (CVI) and choroidal thickness (CT) in patients with unilateral rhegmatogenous retinal detachment (RRD) with operated eyes and fellow healthy eyes.

METHODS

We retrospectively collected demographic and clinical data from 36 patients who underwent 23G pars plana vitrectomy and SO tamponade for unilateral complicated RRD. Enhanced depth imaging-optical coherence tomography (EDI-OCT) scans were performed both within 1 week before SO removal and at the last follow-up visit after SO removal. Using ImageJ software, images were binarized to segment the total choroidal area, luminal area, and stromal area, respectively. The CVI was calculated as CVI=(luminal area)/(total choroidal area), and CT was also evaluated.

RESULTS

During SO tamponade, the CVI and luminal area in operated eyes were significantly lower compared to fellow eyes (57.616 ± 0.030 vs. 60.042 ± 0.019, P < 0.0001; 0.909 [0.694; 1.185] vs. 1.091 [0.785; 1.296], P = 0.007). Even after SO removal, the CVI remained lower in operated eyes than in fellow eyes (59.530 ± 0.018 vs. 60.319 ± 0.020, P = 0.031). Both CVI and luminal area were lower in operated eyes before SO removal than after SO removal (57.616 ± 0.030 vs. 59.530 ± 0.018, P = 0.0003; 0.909 [0.694; 1.185] vs. 0.994 [0.712; 1.348], P = 0.028). The duration of SO tamponade was positively correlated with the difference in CVI between fellow eyes and operated eyes during SO tamponade (P = 0.035). Total choroidal area, stromal area, and CT did not differ significantly between fellow eyes and operated eyes or between pre- and post-SO removal.

CONCLUSIONS

SO tamponade reduces CVI and decreases choroidal blood circulation in patients with retinal detachments required vitrectomy combined with SO tamponade. The longer the SO tamponade time, the more CVI reduction. In future work, we will aim to reduce these side effects by shortening the duration of silicone oil filling.

Macular Parameters Change during Silicon Oil Tamponade for Retinal Detachment Surgery

Background and Objectives: To evaluate possible changes in macular thickness parameters during and after silicon oil tamponade and in pars plana rhegmatogenous retinal detachment surgery. Materials and Methods: Our retrospective study included 34 consecutive patients who underwent 23-gauge retinal detachment surgery with silicon oil tamponade. Central macular thickness (CMT), central macular volume cube (CMV) and average macular thickness cube (AVG) were measured by optical coherence tomography (OCT) before rhegmatogenous retinal detachment surgery with silicon oil tamponade during tamponade (seven days, one month and three months after surgery), and one month after silicon oil removal. Results: In our sample, macular parameters CMT, CMV and AVG in patients who underwent retinal detachment surgery were statistically reduced during silicon oil tamponade (p < 0.05). After silicon oil removal, all parameters recovered, reaching numeric values which were not statistically significant compared to preoperative values. The average span of silicon oil tamponade was 162 +/- 23 days. Conclusions: Silicon oil tamponade during 23-gauge rhegmatogenous retinal detachment surgery leads to a transitory reduction of central macular thickness, central macular volume cube and average macular thickness cube in eyes that underwent retinal surgery. After silicon oil removal, macular parameters returned to preoperative values in most of the patients.

Effect of silicone oil on retinal microcirculation after vitrectomy for rhegmatogenous retinal detachment evaluated by OCT angiography: a literature review

Silicone oil (SO) has been widely used as intravitreal tamponade agent for rhegmatogenous retinal detachment (RRD) and has been occasionally associated with incomplete retinal structural and functional recovery. The use of Optical Coherence Tomography Angiography (OCT-A) has recently attracted significant attention for detailed analysis of retinal capillary plexus and blood flow changes as predicting factors for postoperative outcomes. A detailed literature search was performed in PubMed database until October 2022. The following keywords were used: rhegmatogenous retinal detachment, silicone oil, optical coherence tomography angiography, macular microvasculature, peripapillary capillary plexus, vessel density, and foveal avascular zone. We identified and reviewed 19 studies referring to microcirculation alterations of the retinal capillary plexus as seen on OCT-A in eyes treated by vitrectomy with intravitreal SO for RRD. A comprehensive update revealed variability of microcirculation characteristics of the retinal capillary plexus including the macular and the peripapillary capillaries. Further studies are warranted to clarify the OCT-A values in an attempt to identify the potential effect of SO on retinal tissue in clinical practice. A review of the existing literature sheds light on the effect of SO on retinal capillary plexus and the potential impact on functional outcomes after vitrectomy for RRD. This article discusses important aspects of key publications on the topic, highlights the importance to identify distinct alterations of the microvasculature status, and proposes the need for further future research in this field.

Retinal and Corneal Changes Associated with Intraocular Silicone Oil Tamponade

Silicone oils (SO) are used as long-term intraocular tamponades and have an irreplaceable role in vitreoretinal surgery. They can, however, be associated with multiple and potentially severe complications, involving different ocular tissues, in particular retina and cornea. Recent advances in ophthalmic imaging have allowed the precise characterization of retinal and corneal microstructural changes, at a subclinical level. This detailed analysis of SO-related retinal and corneal changes has improved our understanding of their pathogenesis and offer the potential for optimized monitoring and management of patients with SO-filled eyes. This review aims to provide clinicians and ophthalmic scientists with an updated and comprehensive overview of the corneal and retinal changes associated with SO tamponade.

Comparison of Retinal Changes Following Silicone Oil and Perfluoropropane Gas Tamponade for Proliferative Diabetic Retinopathy Patients

Purpose: To investigate the different tamponade effects of intravitreal silicone oil (SO) and perfluoropropane gas on the retinal structure and vasculature in proliferative diabetic retinopathy (PDR) patients.

Methods: Thirty-eight eligible patients (47 eyes) with PDR requiring pars plana vitrectomy (PPV) were enrolled in the prospective observational study. Subjects were divided into two groups after PPV: SO group subjects underwent SO tamponade, whereas Gas group subjects underwent perfluoropropane gas tamponade. The primary outcomes of this study were longitudinal changes in retinal structure and vasculature between 10 and 90 days after the operation. Secondary outcomes were longitudinal changes in peripapillary retinal nerve fiber layer (pRNFL) thickness between 10 and 90 days after the operation in each sector.

Results: Thirty-six eyes of 27 patients with a median age of 56.6 ± 9.8 years completed follow-up and were statistically analyzed. No significant difference in demographics or clinical characteristics was found between the two groups. Eyes in the SO group had a statistically significant decrease in pRNFL thickness at 90 days after PPV (p < 0.001), and there was a significant intergroup difference compared with the Gas group (p = 0.001), except for the temporal sector. Eyes in the Gas group had a statistically significant increase in parafoveal vessel density (VD) of the superficial vascular complex (SVC) at 90 days after PPV (p = 0.023), although there was no significant intergroup difference. The type of tamponade, changes in full retina thickness, and parafoveal SVC VD showed a significant correlation with changes in pRNFL thickness (all p < 0.05).

Conclusion: SO tamponade resulted in a significantly greater decrease in pRNFL over 90 days than gas tamponade in patients with PDR. In addition, the change in the pRNFL was significantly correlated with changes in full retina thickness and SVC VD after the operation.

Longitudinal evaluation of retinal thickness and OCTA parameters before and following silicone oil removal in eyes with macula-on and macula-off retinal detachments

BACKGROUND

To investigate the longitudinal retinal vascular and structural alterations by using OCTA following successful repair of retinal detachment (RD) by using silicone oil (SO) endotamponade.

METHODS

A prospective cohort study was performed on 24 eyes of 24 subjects; 17 of them with macula-off and seven with macula-on RD. At least four OCTA scans were generated for each study eye; two before and two after SO removal (SOR). At each session, retinal thickness (RT), vascular density (VD) in the superficial (SCP) and deep capillary plexuses (DCP) and foveal avascular zone(FAZ) size were measured within the fovea, parafovea and whole macular image. The changes in repeated measures of the same parameters especially before and after SOR were performed and compared within macula-on and macula-off groups and between fellow eyes.

RESULTS

"In the macula-off eyes, RT measurements within the whole macula, fovea and parafovea reduced as compared with their fellow eyes(p < 0.0001, p = 0.001 and p < 0.0001, respectively) and did not improve after SOR. Additionally, all of the whole macular, foveal, and parafoveal VD measurements at SCP and foveal VD at DCP were less than their fellow eyes after SOR (p = 0.026, p = 0.023 p = 0.026, and p = 0.002, respectively). In macula-on eyes, RT measurements decreased within the parafovea and whole macular area before SOR (p = 0.018 and p = 0.011, respectively) but improved after SOR. Also, VD measurements did not change during follow-up and were not statistically different than their fellow eyes (p > 0.05). FAZ enlargement was found in eyes with macular-off RD after SOR, whereas it was not observed with macular-on RD (p = 0.038and p = 0.237, respectively).

CONCLUSIONS

Treatment of macula-off RD with SO tamponade has been associated with vascular retinal abnormalities which did not improve following SOR. On the contrary, successful treatment of RD with SO tamponade in macula-on eyes VD measurements of SCP and DCP were not statistically different than their fellow eyes.

Macular microcirculation changes after macula-off rhegmatogenous retinal detachment repair with silicone oil tamponade evaluated by OCT-A: preliminary results

Background:

Rhegmatogenous retinal detachment (RRD) with macular involvement is a sight-threatening condition. Silicone oil (SO) is efficacious for retinal tamponade, especially in complex cases. Whether macular detachment per se or the potential tamponading agent may affect macular microcirculation after RRD repair is a matter of research.

Objectives:

To investigate macular microcirculation changes using optical coherence tomography angiography (OCT-A) after pars plana vitrectomy (PPV) with intravitreal SO for RRD repair in the early posttreatment period.

Design:

Prospective comparative cross-sectional study.

Data sources and Methods:

Fourteen eyes of 14 patients were included in the study. All eyes underwent a single successful PPV with SO tamponade for macula-off RRD. OCT-A was performed to analyze macular microcirculation and visual outcomes at 1 month postoperatively. The fellow unaffected eye was used as control.

Results:

Vessel density (VD) in the superficial capillary plexus (SCP) was significantly lower at each macular region (fovea, parafovea, and perifovea) of SO-treated eyes compared with the fellow eyes (all p = 0.001). Similarly, perfusion density (PD) in the SCP was significantly lower at each macular region than the fellow eyes (all p = 0.001). There was enlargement of foveal avascular zone (FAZ) area and decrease of circularity at RRD eyes compared with the fellow ones (all p = 0.001). Postoperative logMAR visual acuity (VA) was significantly lower in treated eyes than fellow eyes and correlated inversely with foveal, parafoveal, and perifoveal VD and PD SCP (all p < 0.001). Postoperative VA had no correlation with FAZ parameters.

Conclusion:

Enlargement of FAZ SCP and decrease in VD and PD SCP during the short-term follow-up were possibly attributable to ischemic changes in the macular area after RRD repair with SO tamponade. In this preliminary study, the flow density in macular capillary plexus may represent an indicator of visual outcomes.

The effect of silicone oil tamponade on retinal layers and choroidal thickness in patients with rhegmatogenous retinal detachment: a systematic review and meta-analysis

Background

To evaluate the effects of intravitreal silicone oil (SO) on the retinal and choroidal thickness in eyes with rhegmatogenous retinal detachment (RRD).

Methods

A literature search was performed in Web of Science, Scopus, ProQuest, Embase, Clinical Key, Science Direct, Cochrane Library, and Springer, as well as Persian databases, including IranDoc, MagIran, SID, MOH thesis, and MOH articles until June 2020. Two reviewers independently searched and extracted the data.

Results

Sixteen studies (n = 391) met the inclusion criteria. The meta-analysis showed that the SO tamponade could significantly reduce the central macular thickness (CMT) in patients with RRD as compared to gas tamponade WMD = − 14.91; 95% CI: − 22.23, − 7.60; P < 0.001, I² = 71%). No significant change was found in CMT between the eye with SO tamponade (after SO removal) and the fellow healthy eye in patients with RRD (WMD = − 3.52; 95% CI: − 17.63, 10.59; I² = 68.6%). Compared to the preoperative stage, the SO tamponade could significantly reduce the subfoveal choroidal thickness in patients with RRD (WMD = − 18.67, 95% CI: − 30.07, − 1.28; I² = 80.1%). However, there was no significant difference in the subfoveal choroidal thickness before and after SO removal (WMD = − 1.13, 95% CI: − 5.97, 3.71; I² = 87.6%).

Conclusion

The SO tamponade had a significant effect on the reduction of retinal layers and the subfoveal choroidal thickness.

Peripapillary changes after vitrectomy and silicone oil tamponade for rhegmatogenous retinal detachment

Purpose:

To evaluate the peripapillary changes after vitrectomy and silicone oil (SO) tamponade in eyes with rhegmatogenous retinal detachment (RRD).

Methods:

In this study, 25-gauge vitrectomy with SO tamponade was performed in 22 eyes with RRD. The radial peripapillary capillary (RPC) vessel density (VD) and retinal nerve fiber layer thickness (RNFLT) were assessed by optical coherence tomography angiography at 2, 4, 8, and 12 weeks postoperatively. The values of healthy fellow eyes were used as controls.

Results:

The global RPC VDs were significantly lower in the eyes with RRD than in fellow healthy eyes at 2 weeks (P < 0.001), and increased at 4 weeks, then decreased over time after surgery (F = 1.046, P = 0.377). The RPC VDs in the superior-hemifield were lower than those in the inferior-hemifield at 12 weeks postoperatively (t = −2.844, P = 0.010). The global RNFLTs decreased gradually after vitrectomy in the eyes with RRD (F = 1.312, P = 0.276). The RNFLTs in the superior-hemifield were thinner than those in the inferior-hemifield at 12 weeks postoperatively (t = −2.222, P = 0.037). The global, superior, and inferior RNFLTs were correlated with corresponding RPC VDs in the eyes with RRD at all time-points postoperatively (P < 0.05).

Conclusion:

RRD resulted in the decrease of RPC VDs. The RPC VDs recovered in the early postoperative period but were still lower than the normal level. Long-term application of SO tamponade resulted in the reduction of peripapillary VDs secondary to loss of RNFLTs.

Silicone oil versus gas tamponade for primary rhegmatogenous retinal detachment treated successfully with a propensity score analysis: Japan Retinal Detachment Registry

Background/aims

To compare the effects of silicone oil tamponade (SOT) to that of gas tamponade (GT) on the best-corrected visual acuity (BCVA) after successful vitrectomy for retinal detachment (RD).

Methods

A retrospective, multicentre, nationwide study with RD who were registered in the Japan-RD Registry. All cases with RD treated with successful vitrectomy between February 2016 and March 2017 were studied. A propensity score matching was performed using the preoperative findings as covariates to adjust the relevant confounders. The primary outcome was the estimated mean difference of the postoperative BCVA in 6 months between eyes treated with SOT to those treated with GT.

Results

Of the 3446 cases registered, 2097 cases met the entry criteria. There were 2042 eyes that had GT and 55 eyes that had SOT. Primary success was defined as a reattached retina with no tamponade at 6 months. After propensity score matching, each group contained 40 cases. The preoperative BCVA was 0.966±0.738 logMAR units in the GT group and 1.270±0.945 logMAR units in the SOT group (p=0.177). Six months postoperatively, the BCVA in the GT group was significantly better at 0.309 logMAR units in the GT group than the 0.671 logMAR units in the SOT group (p=0.002).

Conclusions

Even after successful surgery for RD, eyes that experienced SOT had poorer BCVA than eyes treated with GOT. SOT should be considered cautiously.

Precis

Propensity score analysis of eyes with rhegmatogenous RD showed that postoperative vision was worse in eyes treated once with silicone oil than with gas even after completely successful surgery.