Unfortunately, the retinal detachment repair surgery failed, and he acquired emulsified silicone oil in the anterior chamber (Note the small emulsified bubbles on the back surface of the cornea.
Clinical examination of the posterior segment revealed chronic retinal detachment with proliferative vitreoretinopathy, optic atrophy and macular chorioretinal scarring, which makes silicone oil removal surgery unfeasible.
Retinal detachment surgery with silicone oil tamponade has a primary success rate of 80%, with 10-20% of complex cases showing persistent detachment or redetachment under silicone oil.
Final reattachment after subsequent operations is up to 95-98%. However, retinal damage contributes to poor visual acuity, usually worse than 3/60.
Indications for silicone oil removal in this case:
This would be a highly selective situation, as the eye has no visual potential. Silicone oil removal is to be considered only in cases with silicone oil related complications:
- Silicone oil related keratopathy, corneal decmpensation.
- Uncontrolled glaucoma.
- Silicone in the anterior chamber, causing uveitis or trabeculitis.
Ando iridectomy guards against pupillary block, in cases with silicone oil migration to the anterior chamber. It also reduces chances of keratopathy and glaucoma, as it reduces chances of silicone oil migration to the anterior chamber.
