Session Title: Free Paper Session 5: Anterior/Posterior Segment Surgery
Session Date/Time: Thursday 07/09/2017 | 11:00-12:30
Paper Time: 11:24
Venue: Room 117
First Author: : G.Rabina ISRAEL
Co Author(s): : N. Azem A. Barak A. Loewenstein S. Schwartz
To evaluate the influence of silicone oil (SO) on macular thickness in patients who underwent an anatomically successful retinal detachment (RD) surgery with SO tamponade.
Devision of Ophthalmology, Tel Aviv Sourasky Medical centre, Tel Aviv, Israel
Retrospective, interventional, comparative case series. We reviewed the medical charts of 135 consecutive patients who underwent pars plana vitrectomy for retinal detachment and were left with a SO tamponade (5500 or 1300 centistokes), between 2013-2015. SO was removed few months later in a second planned operation. Optical Coherence Tomography (OCT) was performed with the SO tamponade and one month after SO removal (SOR). Central macular thicknesses (CMT), internal and external layers thickness were measured in the operated eye and in the fellow healthy eye in each patient over the study period of time. Patients with insufficient or poor quality images or with macular pathologies were excluded. Main outcome was the change in macular thickness before and after SOR compared to the healthy eyes.
Thirty patients (17 females and 13 males) were included in the study. Average age was 55±15.7 years. In 66% (20 eyes) of patients the macula was detached at presentation and SO 5500cs was used in 60% (18 eyes) of patients. Average best corrected visual acuity (BCVA) at presentation was 1.02 LogMAR compare to 0.965 after SO insertion and compare to 0.55 after SO removal. Average SO tamponade duration was 153±54 days. We found a statistically significant increase in the mean CMT with 249±52µm compare to 281±56µm after SO removal (p<0.0001). Mean CMT after SOR was similar to the mean CMT of 280±27µm of the normal fellow eyes (p<0.0001). The increase in mean CMT was mainly attributed to changes in the mean thickness of the internal layers with 168±46µm before compare to 196±54µm after SO removal (p<0.0001). CMT in the eye with SO tamponade was strongly correlated with the CMT after SO removal (r=0.847). A positive correlation was found between SO duration and the mean change in CMT (r=0.432). No correlation was found with macula status, silicone type or age (p=0.880, 0.898, 0.775 respectively).
We found that macular thickness decreases in eyes with SO tamponade, mainly in the internal layers. After SOR, the CMT resembles the fellow healthy eyes suggesting a mechanical effect of SO on the retina.