Video Presentation

Silicone oil nightmare

Video Details

First Author: N.P. Ferreira PORTUGAL

Co Author(s):    A. Fernandes Fonseca   C. Marques Neves                          

Abstract Details



Purpose:

Although silicone oil tamponade was able to simplify vitreoretinal surgery by allowing a better prognosis after complex rhegmatogenous retinal detachment surgery, it is a difficult tamponade to handle when compared to gas tamponade. This video shows the surgical revision of a complicated retinal detachment with silicone oil tamponade.

Setting:

ALM - Oftalmolaser, Lisbon; CECV – Centro de estudos da ciência e da visão, Faculdade de Medicina da Universidade de Lisboa

Methods:

70-year-old man, pseudophakic, with a history of right eye macula-off rhegmatogenous retinal detachment treated with 360 degree encircling scleral buckle and 23-gauge pars plana vitrectomy with silicon oil tamponade three months before. One week after silicone oil extraction, a retinal detachment recurrence prompted another 23-gauge vitrectomy with silicone oil tamponade, which resulted in an attached retina with a superotemporal choroidal detachment. Four weeks after the surgery, right eye observation revealed an increased intraocular pressure (32 mmHg), with the anterior chamber filled with silicon oil, and choroidal detachment maintenance. A 23-gauge pars plana vitrectomy revision was performed.

Results:

Removal of the silicone oil in the anterior chamber and choroidal detachment drainage were addressed. Some technical issues related with this complex surgery are also explained. Six months after surgery the retina and choroid are attached with 20/80 best corrected visual acuity on Snellen Scale and good intraocular pressure control.

Conclusions:

Silicone oil not only demands experience, knowledge and time from the retina surgeon but also an insight in the intraoperative and postoperative complications associated with its use. In this video we address some important features associated with a complicated silicone oil tamponade.

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