title: INCREASED INTRAOCULAR PRESSURE IS A RISK FACTOR FOR UNEXPLAINED VISUAL LOSS DURING SILICONE OIL ENDOTAMPONADE.
abstract: OBJECTIVE
  To identify the incidence rate and risk factors for unexplained visual loss associated with silicone oil endotamponade used during primary repair of macula-sparing rhegmatogenous retinal detachments.
  
  
  METHODS
  This retrospective cohort study included patients undergoing pars plana vitrectomy for primary surgical repair of macula-sparing rhegmatogenous retinal detachments in whom silicone oil endotamponade was used. The primary outcome measure was the incidence rate of unexplained visual loss and identification of risk factors associated with vision loss.
  
  
  RESULTS
  Of 1,218 eyes undergoing pars plana vitrectomy for primary retinal detachment repair, 44 eyes were included for analysis. In 9 eyes (20%), an unexplained vision loss occurred. Logistic regression identified increased intraocular pressure (IOP) (prospectively defined as IOP readings during silicone oil endotamponade ≥21 mmHg on two consecutive visits or ≥25 mmHg at any time during this period) as significant predictor (odds ratio = 4.9; P = 0.04) and a classification tree ranked IOP as the most important variable for vision loss. Incidence rate of vision loss in eyes experiencing IOP increase was 4.5 vision loss events per 1,000 days at risk compared with 1 event per 1,000 days in eyes without IOP increase, yielding an incidence rate ratio of 4.5 (95% confidence interval: 1.1-17.9; P = 0.02).
  
  
  CONCLUSIONS
  Sufficient control of IOP during silicone oil endotamponade for primary retinal detachment repair is warranted to reduce the probability of vision loss.
authors.affiliation: Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Marvin
authors.initials: M
authors.lastname: Marti
authors.affiliation: Save Sight Institute, The University of Sydney, Sydney, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Walton
authors.affiliation: Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Böni
authors.affiliation: Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Sandrine A
authors.initials: SA
authors.lastname: Zweifel
authors.affiliation: Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Stahel
authors.affiliation: Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.|Save Sight Institute, The University of Sydney, Sydney, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Barthelmes
mesh_terms: D001766:Blindness / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D058450:Endotamponade / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D011379:Prognosis; D012163:Retinal Detachment / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012827:Silicone Oils / Q000008:administration & dosage / Q000009:adverse effects*; D013557:Switzerland / Q000453:epidemiology; D014821:Vitrectomy / Q000009:adverse effects*
chemical_list: D012827:Silicone Oils