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June 1994

The Efficacy of Silicone Oil for Complicated Retinal Detachments in the Pediatric Population

Author Affiliations

From the Department of Ophthalmology, Duke University Eye Center, Durham, NC. Dr de Juan is currently with The Wilmer Ophthalmological Institute, The Johns Hopkins Hospital, Baltimore, Md. None of the authors has any financial, commercial, or proprietary interests in the instruments and/or methods mentioned in this study.

Arch Ophthalmol. 1994;112(6):773-777. doi:10.1001/archopht.1994.01090180071037

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 postoperatively, 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.

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