Objective  to report anatomical and functional results, as well as complications, of primary vitrectomy with silicone oil for complicated rhegmatogenous retinal detachment (RRD), and to investigate clinical features correlated with anatomical and functional results

Methods  The study reviewed 81 eyes of 76 patients of primary vitrectomy with silicone oil as the initial surgery for complicated RRD. Patients with a history of uveitis, diabetic retinopathy, RRD secondary to ocular trauma, and a follow-up period of less than 3 months were excluded. Main outcomes measures included visual acuity and rates of retinal reattachment, complications, the reasons for bad visual acuity and retinal redetachment and removal of silicone oil. Preoperatively, 56 (69.1%) of 81 eyes were phakic, 41 (50.6%) had PVR, 22 (27.2%) had no break detected and 67 (82.7%) had macular detachment.

Results  The age of patients ranged from 12-85 years old (median: 60) and a median follow-up was 13.1 months (range: 3.6-94.8). The primary and final success rates were 72.8% (59/81) and 95.1% (77/81) respectively. Visual acuities of ≥0.1 was recorded in 38.4% (23/81) preoperatively and 50.6% (41/81) postoperatively. Postoperative PVR was noted in 15 (18.5%) eyes and was the first reason for primary redetachment, followed by a combination of new breaks and PVR, new breaks and old break reopened. The main reasons for final visual acuity less than 0.1 were presumed macular dysfunction, optic nerve atrophy, macular pucker and final unsuccessful reattachment respectively. The clinical features significantly correlated with primary redetachment included preoperative PVR, visual acuity, the removal of the flap of the retinal tear and a combined cataract surgery. The ones for last visual acuity were preoperative visual acuity, a history of retinal laser photocoagulation or cryocoagulation, location of break, superonasal retinal detachment and a combined cataract surgery.

Conclusion  silicone oil is useful as an important intraocular tampnade in the management of complicated retinal detachment, and a high relative rate of retinal reattachment has been achieved. However, the visual acuity is still unsatisfied postoperatively and its reasons are still unclear until now. The optic nerve atrophy resulted from silicone oil might be one of the important reasons.