Silicone oil insertion. A review of 127 consecutive cases.

Silicone oil was used in combination with vitrectomy to treat 127 cases of complicated retinal detachments. An initial anatomic success in 120 cases (94%) was reduced to 68 (54%) after an average follow-up of 32 months and was attributable to ongoing proliferative vitreo-retinopathy (PVR). The indications for the use of silicone oil were: 1. Retinal detachment complicated by PVR (107 cases), 20 of which required multiple operations. Anatomic success was achieved in 59 (55%) and of these 23 (40%) had a visual acuity of 6/60. 2. Giant retinal tears (GRT) (7 cases). Four (57%) of these remained attached, three (75%) having a final vision of 6/36. 3. GRTs complicated by PVR (8 cases). Four (50%) were anatomically successful and two had a final vision of 6/60. 4. Proliferative diabetic retinopathy (5 cases). Two (40%) remained attached and one of these (50%) had hand movements vision. The silicone oil was removed electively in 23 eyes, 16 (70%) of these being anatomically successful. Oil was removed in 43 eyes because of complications, and in 20 (46%) of these, the retina remained attached at the end of follow-up. Complications included cataract in all 14 phakic eyes; rubeosis in 19 eyes (15%); corneal opacification in 52 eyes (41%), there being no clear cut difference between those eyes with an inferior iridectomy (35 of 85 eyes--41%) and those without (12 of 29 eyes--41%); and raised intraocular pressure in 55 eyes (43%). We conclude that although far from being ideal, silicone oil appears to have played some part in achieving the successful results reported in this study.