The efficacy of silicone oil for complicated retinal detachments in the pediatric population
P. J. Ferrone, B. W. McCuen 2nd, E. de Juan Jr and R. Machemer
Department of Ophthalmology, Duke University Eye Center, Durham, NC.
OBJECTIVE: To evaluate the efficacy of silicone oil as an intraocular
tamponade for complicated retinal detachments in the pediatric population.
DESIGN: Case series. SETTING: Referral practice at a major university
hospital eye center. PATIENTS: Consecutive referred sample of 48 cases of
complicated retinal detachments in children 16 years old or younger.
Forty-two percent of the patients had traumatic injuries, and 35 of the
eyes had undergone at least one previous retinal surgery. The minimum
follow-up was 6 months, with an average follow-up of 23 months.
INTERVENTIONS: Pars plana vitrectomy, silicone oil injection, and advanced
vitreoretinal surgical techniques. MAIN OUTCOME MEASURES: Successful repair
of complicated retinal detachment, improved visual acuity post-operatively,
and frequency of complications. RESULTS: The postoperative visual acuity at
the last follow-up examination was counting fingers or better in eight
(17%) of the 48 cases, and only two eyes saw 20/200 or better. In the 46
eyes in which the retinal status could be determined, 16 retinas (35%) were
successfully reattached at last follow-up. Significant complications
included corneal opacification (62%) and hypotony (58%). Postoperative
glaucoma was not a problem. CONCLUSIONS: In the pediatric population with
complicated retinal detachments, silicone oil used for intraocular
tamponade has disappointing results due to a low rate of sustained retinal
reattachment, poor visual rehabilitation, and a high complication rate.
