Long-term visual prognosis and characteristics of recurrent retinal detachment after silicone oil removal

PLOS ONE RESEARCH ARTICLE Long-term visual prognosis and characteristics of recurrent retinal detachment after silicone oil removal Wookyung Park1,2, Mirinae Kim1,2, Rae Young Kim1,2, Joo Young Kim1,2, Jae Hyuck Kwak1,2, Young-Gun Park1,2, Young-Hoon Park ID1,2* a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea, 2 Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea * .k Abstract Purpose OPEN ACCESS Citation: Park W, Kim M, Kim RY, Kim JY, Kwak JH, Park Y-G, et al. (2023) Long-term visual prognosis and characteristics of recurrent retinal detachment after silicone oil removal. PLoS ONE 18(2): e0265162. https://doi.org/10.1371/journal. pone.0265162 Editor: Demetrios G. Vavvas, Massachusetts Eye & Ear Infirmary, Harvard Medical School, UNITED STATES Received: May 17, 2020 Accepted: February 25, 2022 Published: February 8, 2023 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0265162 Copyright: © 2023 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data cannot be shared publicly because of Possibility of personal information leakage. Data are available from the Silicone oil (SO) is commonly used for tamponade purposes in retinal detachment (RD) surgery, but the long-term visual prognosis after removal of the oil, and in particular, what is known about the recurrence of RD after SO removal, remains unclear. The purpose of this study is to evaluate the long-term vision prognosis after SO removal, and to understand the frequency and characteristics of RD recurrence. Methods We retrospectively reviewed the medical charts of 1017 eyes of patients with a diagnosis of RD who had a pars plana vitrectomy with SO tamponade between January 2009 and December 2018. Best-corrected visual acuity (BCVA) was obatained before and after vitrectomy and also at the last visit. After SO removal, the group who showed improvement in visual acuity and the group who did not were compared. The anatomical results were compared between the group in which the retina was detached again after SO removal and the group in which the retina was not detached. To determine whether the duration of SO tamponade affects RD recurrence, further analysis was performed by dividing subgroups according to SO tamponade duration. RD recurrence, visual acuity, SO tamponade period were investigated. Results Mean follow-up period was 56.65 ± 72.02 months. An average SO tamponade period was 6.68 ± 11.39 months. The average logMAR BCVA was 1.75 ± 0.91 before SO injection, 1.60 ± 0.75 before SO removal and 1.29 ± 0.96 after the removal. After SO removal, 926 of the 1017 (91.1%) patients had well attached retina without recurrence. There was no significant difference in visual acuity before SO removal in re-detachment group compared to no redetachment group, but visual acuity of re-detachment group was worse than no re-detachment group after SO removal (p<0.001). The SO tamponade period in the group with PLOS ONE | https://doi.org/10.1371/journal.pone.0265162 February 8, 2023 1 / 11 PLOS ONE Institutional Review Board of the Catholic University of Korea (‘’ and ‘’) for researchers who meet the criteria for access to confidential data. Funding: The author(s) received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist. Recurrent retinal detachment after silicone oil removal improved vision after SO removal was 5.09 ± 9.87 months, and the period was significantly shorter than the 9.09 ± 13.05 months in the group not showing vision recovery (p = 0.005). The occurrence of corneal opacity was significantly higher in the group with SO over 6 months, than those of the two groups with SO tamponade duration of less than 3 months and between 3 and 6 months (p = 0.038). The longest tamponade group showed the worst final vision after SO removal (p<0.001). Conclusion The prognosis for final vision is generally good when performing surgery using SO in RD, but considering the complications that arise after surgery, long-term retention of SO is not recommended and the timing of SO removal should be considered. Introduction Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment (RD) that an ophthalmologist can meet in clinical practice [1]. RRD is one of the emergency diseases in which the ophthalmic prognosis such as vision can rapidly deteriorate when treatment is delayed. In addition to RRD, tractional retinal detachment (TRD) caused by diabetes can also cause severe and rapid loss of vision, and blindness can occur if surgery is not performed [2]. The treatment options include primary scleral buckle, pars plana vitrectomy with tamponade (silicone oil, gas) or a combination of both [3]. Prolonged silicone oil (SO) tamponade can cause complications like cataract, elevated intraocular pressure, hypotony, emulsification and keratopathy [4, 5]. Therefore, it has been suggested that SO should be removed 3 to 6 months after putting it in the eye [6, 7]. Retinal re-detachment is a major complication after removal of SO which ranges from 2% to 33% of cases according to several studies [5, 8]. One of the suggested mechanisms of retinal re-detachment is traction that occurs or worsens after removal of SO in a portion that has been suppressed with the oil [9, 10]. The eyes that had SO removal are filled with water instead of vitreous. Compared to viscous vitreous, body fluids are more likely to enter tiny retinal holes and cause RD recurrence. SO removal is somewhat common surgical procedure in several vitreoretinal diseases, but it is still unclear in terms of long-term visual prognosis after a removal of the oil. Meanwhile not so much of characteristics of re-detachment of retina is unfolded yet. The purpose of this study is to evaluate the long-term visual prognosis and determine the frequency and characteristics of retinal re-detachment after SO removal in RD patients. Patients and methods This study was carried out retrospectively and followed the Declaration of Helsinki. An approval was obtained from the Institutional Review Board of the Catholic University of Korea. Considering the aspect of retrospective study, necessity of obtaining informed patient consent was waived. All patients were recruited between January 2009 and December 2018 at Seoul St. Mary’s Hospita (...truncated)