Primary silicone oil tamponade in the management of severe intraocular foreign body injuries: an 8-year follow-up.
OBJECTIVE
To evaluate the long-term outcome of pars plana vitrectomy and primary silicone oil tamponade in patients with severe intraocular foreign body (IOFB) injuries and high risk of proliferative vitreoretinopathy (PVR).


METHODS
This retrospective consecutive study included 23 patients with severe IOFB injuries who had extensive lacerations including sclera, choroid, and retina, and were complicated by predictive factors for elevated proliferative activity and an unfavorable outcome. All patients underwent pars plana vitrectomy, removal of the IOFB, and primary silicone oil tamponade and were followed up for a mean 8.9 years. Main functional outcome was assessed as final best-corrected visual acuity. Anatomic success was defined as permanent retinal attachment.


RESULTS
PVR occurred in 70% of all eyes and required 16 revisions. Silicone oil was removed in 78% of the eyes after a mean tamponade duration of 9.1 months. Complete retinal attachment was achieved in 83% of the eyes. Three eyes developed a persisting hypotony that was stabilized under permanent silicone oil. Functional stabilization was observed in the third year resulting in a final visual acuity of 20/630. Useful vision of better than 20/400 could be preserved in 55% of the patients. Only one eye underwent a late enucleation after 6.8 years.


CONCLUSIONS
Primary silicone oil stabilizes the retina during the critical period of active PVR and may limit the visual loss in selected high-risk eyes in the long term.
Szurman
Peter
P
Department of Ophthalmology I, University of Tuebingen, Tuebingen, Germany. Peter.Szurman@med.uni-tuebingen.de
Roters
Sigrid
S
Grisanti
Salvatore
S
Aisenbrey
Sabine
S
Rohrbach
Jens M
JM
Warga
Max
M
Gelisken
Faik
F
Spitzer
Martin S
MS
Bartz-Schmidt
Karl U
KU
D000293:Adolescent; D000328:Adult; D002829:Choroid / Q000293:injuries; D003131:Combined Modality Therapy; D004322:Drainage; D005129:Eye Foreign Bodies / Q000628:therapy*; D015807:Eye Injuries, Penetrating / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D022125:Lacerations / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012160:Retina / Q000293:injuries; D012189:Retrospective Studies; D012590:Sclera / Q000293:injuries; D012827:Silicone Oils / Q000008:administration & dosage*; D016896:Treatment Outcome; D014792:Visual Acuity; D018630:Vitreoretinopathy, Proliferative / Q000517:prevention & control
D012827:Silicone Oils