Retinal Redetachment after Silicone Oil Removal in Proliferative Vitreoretinopathy: A Prognostic Factor Analysis

Abstract

Purpose: To determine the prognostic factors associated with retinal redetachment after 1300-centistokes silicone oil removal in rhegmatogenous retinal detachments (RDs) associated with grade C proliferative vitreoretinopathy (PVR). Design: Nonrandomized, retrospective, comparative interventional trial. Methods: One hundred and forty-seven eyes with RD and grade C PVR treated with silicone oil tamponade, with subsequent silicone oil removal, in an institutional setting. Main outcome measures included anatomic success, defined as complete retinal attachment after silicone oil removal, and best-corrected visual acuity (BCVA) after silicone oil removal. Results: Silicone oil was removed after a mean tamponade period of 12.4 ± 9.8 months. The mean follow-up after silicone oil removal was 22.1 ± 18.7 months (range, 6.0 to 71.0 months). The retina remained attached in 120 eyes after oil removal. The overall anatomic success rate was 81.6% ± 3.2%. Logistic regression showed that an increased number of previous unsuccessful RD surgeries (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.19 to 0.80; P = .010) and longer axial lengths (OR, 0.42; 95% CI, 0.15 to 0.87; P = .032) were associated with a lower anatomic success rate. Previous vitrectomy, previous scleral buckling procedure, 12% perfluoropropane-air exchange immediately after silicone oil removal, and duration of silicone oil tamponade were not statistically associated with the anatomic success rate. Anatomic success was associated with a significantly better BCVA (1.169 ± 0.475 vs 1.520 ± 0.381 logarithm of the minimum angle of resolution; P < .001). Conclusions: The number of previous surgeries and axial length, rather than the nature of the previous surgical procedures, were significant prognostic factors for anatomic success after silicone oil removal. © 2008 Elsevier Inc. All rights reserved.