The Efficacy of Primary Silicone Oil Tamponade in Vitrectomy for Proliferative Diabetic Retinopathy

ABSTRACT

PURPOSE: To evaluate the clinical efficacy for primary application of the silicone oil tamponade in vitrectomy for severe proliferative diabetic retinopathy. METHODS: We did retrospective clinical analysis on the preoperative and postoperative fundus findings, visual results, postoperative complications in 26 patients (30 eyes) with severe proliferative diabetic retinopathy who vitrectomy and intravitreal silicone oil injection were performed simultaneously as initial operation. RESULTS: Vitrectomy with silicone oil injection was performed in 14 eyes (46.7%) with severe traction retinal detachment involving macula, 10 eyes (33.3%) showed severe intraoperative hemorrhage among the cases that iatrogenic retinal tear was developed in the eyes with traction retinal detachment and 6 eyes (20.0%) with combined tractional and rhegmatogenous retinal detachment, and silicone oil was removed postoperatively on mean 2.7months (1.4~6.0 months) in 28 eyes of the total of 30 eyes. Final anatomic success was obtained in 26 eyes (86.7%) and functional success in 23 eyes (76.7%), and there was visual improvement of mean 2.8, 1.9 lines and improvement over 2 lines in 17 (56.7%), 11 (36.7%) eyes for best and final visual acuity comparing to preoperative visual acuity, respectively. Postoperative complications included cataract formation and aggravation in 24 or 25 phakic eyes(96.0%), recurrent preretinal membrane in 10 eyes (33.3%), retinal detachment in 10 eyes (33.3%), neovascular glaucoma in 5 eyes (16.7%), vitreous hemorrhage in 3 eyes (10.0%), and phthisis, band keratopathy, endophthalmitis in 1 eye (3.3%) respectively. CONCLUSIONS: In the proliferative diabetic retinopathy that difficulty in the retinal reattachment is predicted or that has high risk of the rebleeding, early application of the silicone oil tamponade is expected to be a useful tool for primary vitrectomy.