J Korean Ophthalmol Soc.  2012 Sep;53(9):1296-1303. 10.3341/jkos.2012.53.9.1296.

Surgical Outcome and Significance of Silicone Oil Tamponade for Inferior Rhegmatogenous Retinal Detachment

• Seo SJ
• Lee SJ
• Park JM

• KMID: 2216083
• DOI: http://doi.org/10.3341/jkos.2012.53.9.1296

Abstract

PURPOSE
To compare the surgical outcomes of 23-gauge transconjunctival sutureless vitrectomy (TSV) with silicone oil tamponade versus 20-gauge PPV with sclera buckling (SB) and SF6 gas tamponade for the repair of rhegmatogenous retinal detachment (RRD) with inferior breaks. In addition, silicone oil tamponade was evaluated as an alternative option for patients with inferior RRD.
METHODS
Two different types of surgery were performed on two groups of patients with inferior RRD: 23-gauge TSV with silicone oil tamponade (group 1) and 20-gauge PPV with SB and SF6 gas tamponade (group 2). The preoperative clinical features, anatomical success rate, complications, functional outcomes (visual acuity, VA, intraocular pressure, IOP), and surgical time were retrospectively evaluated.
RESULTS
The primary surgical success rates were 94% and 78% in groups 1 and 2, respectively. The final success rate was 100% in both groups. Therefore, in terms of success rate, there was no difference between the two groups. No statistically significant difference in IOP change or complication rate was observed between the two groups. VA change was significantly better and surgical time was shorter in group 1.
CONCLUSIONS
No statistically significant difference of anatomical success rate or complication rate between 23-gauge TSV with silicone oil tamponade and 20-gauge PPV with SB and SF6 gas tamponade was found for inferior RRD. However, surgical time was shorter in group 1. A 23-gauge TSV with silicone oil tamponade could be an alternative to 20-gauge PPV with SB and SF6 gas tamponade for patients with inferior RRD, especially patients who cannot maintain a prone posture.

Keyword

Inferior rhegmatogenous retinal detachment; Scleral buckling; Silicone oil tamponade; 23-gauge transconjunctival sutureless vitrectomy

MeSH Terms

Humans
Intraocular Pressure
Operative Time
Posture
Retinal Detachment
Retinaldehyde
Retrospective Studies
Sclera
Scleral Buckling
Silicone Oils
Vitrectomy
Retinaldehyde
Silicone Oils

Reference

1. Gonin J. The treatment of detached retina by searing the retinal tears. Arch Ophthalmol. 1930. 4:621–625.

2. Custodis E. Importance of the Vitreous Body in Retina Surgery with Special Emphasis on Reoperations. 1960. 1st ed. St. Louis: CV Mosby;75–78.

3. Machemer R, Buettner H, Norton EW, Parel JM. Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otolaryngol. 1971. 75:813–820.

4. Han DP, Mohsin NC, Guse CE, et al. Southern Wisconsin Pneumatic Retinopexy Study Group. Comparison of pneumatic retinopexy and scleral buckling in the management of primary rhegmatogenous retinal detachment. Am J Ophthalmol. 1998. 126:658–668.

5. Park JL, Kim SD, Yun IH. A clinical study of the rhegmatogenous retinal detachment. J Korean Ophthalmol Soc. 2002. 43:1015–1024.

6. Wickham L, Connor M, Aylward GW. Vitrectomy and gas for inferior break retinal detachments: are the results comparable to vitrectomy, gas, and scleral buckle? Br J Ophthalmol. 2004. 88:1376–1379.

7. Mokete B, Williamson TH. Scleral buckling combined with vitrectomy for the management of rhegmatogenous retinal detachment associated with inferior retinal breaks. Eye (Lond). 2009. 23:1233. author reply 1233-4.

8. Alexander P, Ang A, Poulson A, Snead MP. Scleral buckling combined with vitrectomy for the management of rhegmatogenous retinal detachment associated with inferior retinal breaks. Eye (Lond). 2008. 22:200–203.

9. Meyers SM, Foster RE. Choroidal hemorrhage after Valsalva's maneuver in eyes with a previous scleral buckle. Ophthalmic Surg. 1995. 26:216–217.

10. Tabandeh H, Sullivan PM, Smahliuk P, et al. Suprachoroidal hemorrhage during pars plana vitrectomy. Risk factors and outcomes. Ophthalmology. 1999. 106:236–242.

11. Flindall RJ, Norton EW, Curtin VT, Gass JD. Reduction of extrusion and infection following episcleral silicone implants and cryopexy in retinal detachment surgery. Am J Ophthalmol. 1971. 71:835–837.

12. Yoshida A, Feke GT, Green GJ, et al. Retinal circulatory changes after scleral buckling procedures. Am J Ophthalmol. 1983. 95:182–188.

13. Sato EA, Shinoda K, Inoue M, et al. Reduced choroidal blood flow can induce visual field defect in open angle glaucoma patients without intraocular pressure elevation following encircling scleral buckling. Retina. 2008. 28:493–497.

14. Kimura I, Shinoda K, Eshita T, et al. Relaxation of encircling buckle improved choroidal blood flow in a patient with visual field defect following encircling procedure. Jpn J Ophthalmol. 2006. 50:554–556.

15. Goezinne F, La Heij EC, Berendschot TT, et al. Anterior chamber depth is significantly decreased after scleral buckling surgery. Ophthalmology. 2010. 117:79–85.

16. Kwartz J, Charles S, McCormack P, et al. Anterior segment ischaemia following segmental scleral buckling. Br J Ophthalmol. 1994. 78:409–410.

17. Hayashi H, Hayashi K, Nakao F, Hayashi F. Corneal shape changes after scleral buckling surgery. Ophthalmology. 1997. 104:831–837.

18. Leibovitch I, Crompton J, Selva D. New onset diplopia: 14 years after retinal detachment surgery with a hydrogel scleral buckle. Br J Ophthalmol. 2005. 89:640.

19. Fison PN, Chignell AH. Diplopia after retinal detachment surgery. Br J Ophthalmol. 1987. 71:521–525.

20. Heimann H, Bartz-Schmidt KU, Bornfeld N, et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology. 2007. 114:2142–2154.

21. Heimann H, Zou X, Jandeck C, et al. Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of 512 cases. Graefes Arch Clin Exp Ophthalmol. 2006. 244:69–78.

22. Tanner V, Minihan M, Williamson TH. Management of inferior retinal breaks during pars plana vitrectomy for retinal detachment. Br J Ophthalmol. 2001. 85:480–482.

23. Ozdek S, Kiliç A, Gurelik G, Hasanreisoglu B. Scleral buckling technique for longstanding inferior rhegmatogenous retinal detachments with subretinal bands. Ann Ophthalmol (Skokie). 2008. 40:35–38.

24. Hotta K, Sugitani A, Uchino Y. Pars plana vitrectomy without long-acting gas tamponade for primary rhegmatogenous retinal detachment. Ophthalmologica. 2004. 218:270–273.

25. Schwartz SG, Kuhl DP, McPherson AR, et al. Twenty-year follow-up for scleral buckling. Arch Ophthalmol. 2002. 120:325–329.

26. Cibis PA, Becker B, Okun E, Canaan S. The use of liquid silicone in retinal detachment surgery. Arch Ophthalmol. 1962. 68:590–599.

27. The Silicone Study Group. Vitrectomy with silicone oil or sulfur hexafluoride gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial. Silicone Study Report 1. Arch Ophthalmol. 1992. 110:770–779.

28. The Silicone Study Group. Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial. Silicone Study Report 2. Arch Ophthalmol. 1992. 110:780–792.

29. Abrams GW, Azen SP, McCuen BW 2nd, et al. Vitrectomy with silicone oil or long-acting gas in eyes with severe proliferative vitreoretinopathy: results of additional and long-term follow-up. Silicone Study report 11. Arch Ophthalmol. 1997. 115:335–344.

30. Martínez-Castillo V, Verdugo A, Boixadera A, et al. Management of inferior breaks in pseudophakic rhegmatogenous retinal detachment with pars plana vitrectomy and air. Arch Ophthalmol. 2005. 123:1078–1081.

31. Campo RV, Sipperley JO, Sneed SR, et al. Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachments. Ophthalmology. 1999. 106:1811–1815.

32. Heimann H, Bornfeld N, Friedrichs W, et al. Primary vitrectomy without scleral buckling for rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 1996. 234:561–568.

33. Romano MR, Stappler T, Marticorena J, et al. Primary vitrectomy with Densiron-68 for rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 2008. 246:1541–1546.

34. Romano MR, Angi M, Valldeperas X, et al. Twenty-three-gauge pars plana vitrectomy, Densiron-68, and 360° endolaser versus combined 20-gauge pars plana vitrectomy, scleral buckle, and SF6 for pseudophakic retinal detachment with inferior retinal breaks. Retina. 2011. 31:686–691.

35. Meng Q, Zhang S, Cheng H, et al. Long-term outcomes of Oxane Hd as intraocular tamponade in the treatment of complicated retinal detachment. Graefes Arch Clin Exp Ophthalmol. 2010. 248:1091–1096.

36. Park YM, Lee JE, Oum BS. Comparisons of corneal topographic change between 20-gauge and 23-gauge pars plana vitrectomy. J Korean Ophthalmol Soc. 2009. 50:353–358.