Clinical Outcomes After Intraocular Silicone Oil Removal and Analysis of Its Prognostic Factors

PURPOSE: To evaluate the factors influencing clinical outcome after removal of intraocular silicone oil and the relationship of the factors to the postoperative visual prognosis. METHODS: The authors retrospectively analyzed clinical outcomes related to 76 patients (79 eyes) who underwent silicone oil tamponade. Prognostic factors were as follows: age, underlying pathologies, systemic diseases, range and type of retinal detachment (RD), type of RD, number of retinal tears, macular and lens status, and types of operation. The influence of these factors on visual acuity and anatomical success rates were studied. RESULTS: The 79 eyes that underwent silicone oil removal had preoperative diagnoses as follows: proliferative diabetic retinopathy in 32 eyes, primary rhegmatogenous RD in 12 eyes, RD with an intraocular foreign body in nine eyes, traumatic RD in eight eyes, RD with a macular hole in six eyes, RD development after other surgeries in six eyes, RD with endophthalmitis in three eyes, and RD with high myopia in three eyes. Anatomical success was achieved in 59 eyes (74.7%) after silicone oil removal. Thirty-two eyes (40.5%) had an increase in visual acuity, 28 eyes (35.4%) showed no changes and 19 eyes (24.1%) showed deteriorated conditions after silicone oil removal. The number of surgeries was an important factor related to anatomical and functional success rate. Postoperative visual improvement was observed when the number of surgeries was greater than two and in groups with no macular holes or degenerations. CONCLUSIONS: When considering prognostic factors for silicone oil removal, reducing complications and retinal redetachment after silicone oil removal may be helpful.

Clinical Evaluation of Radiation Retinopathy

PURPOSE: To assess variable clinical findings and risk factors of radiation retinopathy and to evaluate the effects of laser photocoagulation. METHODS: We reviewed the medical charts of 55 patients who received fractionated external-beam radiation during the treatment of head and neck tumors and who had a minimum of 2 years of follow-up from January 1996 to June 2002. RESULTS: Thirteen eyes in 8 patients developed radiation retinopathy. The mean time to the onset of symptoms attributable to retinal ischemia was 28 months (range, 15 to 43 months). The most common initial visual symptom was decreased visual acuity. Retinal hemorrhages, hard exudates and cotton wool spots were frequently observed fundus findings, and capillary non-perfusion on fluorescein angiography was the invariable findings. The mean total radiation dose was significantly higher in the retinopathy positive group (66.9+/-5.7 Gy) than in the retinopathy negative group (55.4+/-15.8 Gy) (P<0.05). Laser photocoagulation was performed in nine eyes of which 7 had good prognosis for retaining and regaining good central vision at the last follow-up. CONCLUSIONS: Although radiation retinopathy is infrequent, the long-term visual outcome is good with adequate laser photocoagulation treatment when detected early by close and regular follow-up.