Effectiveness of Silicone Oil Tamponade with Pars Plana Vitrectomy in Isolated Cases of Vitreous Hemorrhage with Advanced Diabetic Retinopathy

Abstract

Purpose:  To assess the effectiveness and safety of silicone oil as tamponade in vitrectomy performed for isolated cases of vitreous hemorrhage in patients with advanced diabetic retinopathy. Study Design:  Quasi experimental. Place and Duration of Study:  Al-Ibrahim Eye Hospital, Karachi from October 2022 to March 2023. Methods:  Forty two cases of advanced diabetic retinopathy (either sex), with developing vitreous hemorrhage (active bleeding) were enrolled through convenient sampling. Demographic characteristics and pre-operative examination of eyes including Best corrected visual acuity (BCVA), intraocular pressure (IOP), indirect ophthalmoscopy, gonioscopy and ultrasonography (in cases where fundus was not visible) were performed. All the patients underwent pars plana vitrectomy (PPV) and pan retinal photocoagulation (PRP). Silicone oil was used as tamponade. Post-operative follow up was at first week after surgery and repeated at 3rd month and 6th month. Effect of silicon oil tamponade on re-bleeding after surgery was specifically observed. Anatomical outcome and side effects were also noted during the study period. Results:  Out of 42 cases, re-bleed occurred in 2 cases (4.76 %). However, intraocular pressure (IOP) was raised in 3cases (7.1%) and cataract formed in 2 cases (4.76%). No other side effect was observed throughout the study period. Conclusion:  Use of silicone oil as tamponade effectively decreases re-bleeding in patients of advanced diabetic retinopathy after vitrectomy. However, few complications such as increased intraocular pressure and cataract can occur that are manageable both medically and surgically.