Visual results of silicone removal in patients undergoing phacovitrectomy for a diagnosis of rhegmatogenous retinal detachment.

Abstract

SUMMARY

Introduction: Rhegmatogenous retinal detachment (RRD) is characterized by the presence of a retinal break associated with vitreoretinal traction that allows liquefied vitreous to pass into the subretinal space. This causes hydraulic dissection because the force of fluid passage through the retinal break exceeds the normal forces that keep the retina adhered to the RPE.

One treatment option is the use of silicone oil (SO) during phacovitrectomy in patients with RRD. The theoretical basis lies in the surface tension provided by the oil across the retina, which prevents the flow of fluid into the subretinal space until retinopexy provides early and sustained adhesion.

The potential toxicity of silicone oil to the retina has been studied, but it remains a controversial topic.

This topic is of interest due to ongoing controversies regarding the limited evidence on silicone oil toxicity, the optimal timing for its removal after phacovitrectomy, and its relationship with unexplained visual loss after oil removal.

Objective: To evaluate visual acuity outcomes at 6 and 12 months after silicone oil removal in patients diagnosed with rhegmatogenous retinal detachment who previously underwent cataract surgery with intraocular lens implantation and pars plana vitrectomy with silicone oil as an endotamponade.

Methodology: This is a historical cohort study of patients who underwent deliberate surgical intervention. Outcomes will be measured longitudinally in a self-controlled trial format comparing before and after the intervention. These measurements will be taken prior to silicone oil removal, and at 6 and 12 months after its removal from the vitreous cavity.

Expected results: Patients diagnosed with retinal detachment who received phacovitrectomy surgery with silicone oil as an endotamponade, followed by a second surgery for oil removal, are expected to improve by 3 lines of vision.

Estimated duration of the protocol: 11 months.