Refractive status and visual acuity changes after oil removal in eyes following phacovitrectomy, intraocular lens implantation, and silicone oil tamponade.

OBJECTIVE

To examine the refractive changes in pseudophakic eyes with silicone oil tamponade (SOT) and removal.

DESIGN

Retrospective review.

PARTICIPANTS

Twenty-six consecutive eyes (23 patients) that had undergone phacovitrectomy, posterior chamber intraocular lens (IOL) implantation, and SOT by a single surgeon.

METHODS

Phacoemulsification and biconvex-type foldable acrylic IOLs were implanted. A standard 3-port pars plana vitrectomy was performed using a 20-gauge vitrectomy system. Following fluid-air exchange, 1300 centistokes silicone oil (SO) was injected. Manifest refractions with SOT and after SO removal were performed using best-spectacle correction based on retinoscopy results at least 1 month after each surgery.

RESULTS

A mean spherical equivalent of 3.85 (SD 1.63) diopters (D) and logMAR best-corrected visual acuity (BCVA) of 0.77 (SD 0.50) were observed with SOT. After SO removal, a myopic shift of -4.51 (SD 1.79) D was observed, resulting in -0.66 (SD 1.40) D, which concurred with the preoperative target of -0.47 (SD 0.50) D (p = 0.465, paired t test) and logMAR BCVA of 0.65 (SD 0.52) (p = 0.131, paired t test). Multivariate linear regression analysis demonstrated that the axial length and refractive index of the IOL were significant factors in determining refraction in oil-filled pseudophakia (p = 0.000).

CONCLUSIONS

Phacovitrectomy, IOL implantation, and SOT resulted in a tolerable range of hyperopia and visual acuity comparable to that after SO removal.