Intraocular silicone oil removal: timing, outcome, and silicone oil complications encountered

Introduction: Silicone oil is the preferred tamponade agent used in pars-plana vitrectomy for retinal detachment when a long duration of endotamponade is intended. Due to its possible long-term complications, removal of silicone oil (ROO) is recommended. Purpose: This study is done to evaluate the mean duration and complications of silicone oil tamponade, and the anatomical and visual outcomes after silicone oil removal. Study design: Retrospective study. Materials and methods: Retrospective review was done on 55 eyes of 55 patients, in which ROO was carried out at Hospital Sultanah Bahiyah in 2016 with a minimum six months follow-up postoperatively. Results: The duration of silicone oil tamponade in these eyes ranged from 1.0 to 55.5 months, with mean duration of 10.8 months (SD 7.74). Common complications of silicone oil tamponade observed were cataract in 30 eyes (54.5%), followed by secondary high intraocular pressure in 6 eyes (10.9%), and band keratopathy in 3 eyes (5.5%). Six eyes (10.9%) developed retinal re-detachment after oil removal.  The majority in the anatomically attached group post ROO (40 eyes, 81.6%) showed improvement of vision after ROO, with mean best corrected vision of LogMAR 1.38 (6/150) with silicone oil in situ to LogMAR 0.88 (6/48) at the latest follow-up. Conclusions: Although the recommended duration of silicone oil tamponade ranges from three to six months, the optimal timing for silicone oil removal still remains unknown. ROO is recommended due to oil-related complications, but the anatomical outcome should be evaluated as well. However, in our setting, with limited resources and time, and increasing number of patients indicated for silicone oil, it is impossible to comply with the recommended time for ROO and the timing is usually set on an individual basis.