Conventional Silicone Oil for Retinal Detachment with Inferior Breaks

Aim: To report the long term results of pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) with conventional silicone oil in the presence of inferior retinal breaks and to compare the results with published data of heavy silicone oil. Design: Retrospective interventional case series study. Method: Forty four consecutive eyes of 43 patients presenting with RRD and inferior retinal breaks were enrolled in this study. Our inclusion criteria included eyes with large, multiple and/or irregular inferior breaks (4 to 8 O’clock), giant retinal tears with large inferior component and eyes with inferior retinotomies (180º or more). Cases presenting with macular hole detachments, diabetic tractional detachments or combined tractional/rhegmatogenous retinal detachments were all excluded from our study. All patients were operated by PPV techniques and 1000cs silicone oil tamponade. No scleral buckling was performed in any of the included eyes. Results: Intraoperative anatomical reattachment was achieved in all 44 eyes. Recurrent retinal detachment before silicone oil removal occurred in 10 eyes, of which; reoperation was performed on 7 eyes and retina was successfully reattached in 5 eyes bringing our success rate to 39/44 eyes (88.6%). After oil removal recurrence occurred in 5 eyes; a redo was performed and retinal reattachment was achieved in 4 eyes. Final success rate was achieved in 38/44 eyes (86.4%) with 4 eyes retaining their silicone oil. Conclusion: The results of this study suggest that conventional silicone oil is an effective tamponade in cases of RRD associated with inferior breaks. Our results are comparable to those of heavy silicone oil with the advantage of less complications and easier manipulation of conventional silicone oil as compared to heavy silicone oil. It is therefore questionable whether there is any need to abandon conventional silicone oil in eyes with RRD associated with inferior breaks or retinotomy.