Résumé
To evaluate the outcomes of internal tamponade using heavy silicone oil in complicated retinal detachment [RD] surgery. In this interventional case series, patients with complicated RD involving the inferior retina were enrolled. Inclusion criteria included RD secondary to proliferative vitreoretinopathy [PVR CP6 and/or CA6] involving the inferior retina, inferior or posterior tears, giant tears, penetrating trauma or RD combined with choroidal detachment. Heavy silicone [Oxan HD, Bausch and Lomb, USA] was injected at the end of surgery after peeling of retinal membranes or retinotomy. Follow-up examinations were scheduled one day, one week, one month and four months after surgery. Additional visits were made depending on the condition of the eye. Seventeen eyes of 17 patients with mean age of 45.4 +/- 12.2 [range 19-71] years underwent vitrectomy and heavy silicone oil tamponade. Mean follow-up was 11.4 +/- 3.5 [range 4-16] months. There was total RD in 10 cases, subtotal RD involving the inferior retina in 6 patients and RD associated with choroidal detachment in one. Best-corrected visual acuity [BCVA] before surgery was LP or HM in 13 eyes and counting fingers at 0.5 to 3 m in 4 eyes. During the follow-up period, the retina remained attached in 12 cases [70/5%] but 5 eyes needed further vitrectomy for reattachment. BCVA improved from 1.95 +/- 0.09 LogMAR preoperatively to 1.5 +/- 0.35 four months after the operation [P=0.045]. After 4 months' follow-up BCVA was HM in 4 eyes and 0.5 m to 20/200 in 13 eyes. Transient IOP rise occurred in one eye and silicone oil emulsification was seen in another eye. Heavy silicone oil tamponade had favorable results in terms of anatomical attachment of the retina and visual acuity