Outcomes of complex retinal detachment repair using 1000- vs 5000-centistoke silicone oil

Objective: To compare anatomic and visual acuity outcomes, as well as complication rates, after retinal detachment repair using 1000- vs 5000-centistoke silicone oil. Methods: Records of all patients who underwent retinal detachment repair with silicone oil at one institution between January 1, 1995, and December 31, 2000, were reviewed. Anatomic outcomes included retinal redetachment and macula-off retinal redetachment. Visual acuity outcomes included ambulatory vision (≥5/200) and change in visual acuity from preoperative examination. Complications included rates of secondary intraocular pressure elevation, hypotony, corneal opacification, cataract, and oil emulsification. Outcomes were assessed at 1 week, 1 month, 3 months, 6 months, and 1 year. Results: The study included 82 eyes that underwent retinal detachment repair with 1000-centistoke silicone oil and 243 eyes that underwent retinal detachment repair with 5000-centistoke silicone oil. Demographic characteristics, cause of retinal detachment, and preoperative ocular characteristics were similar in the 2 groups. There was no significant difference in the rate of retinal redetachment at each of the follow-up intervals investigated. The cumulative retinal detachment rate was also similar between the 2 groups except among trauma cases, for which 1000-centistoke silicone oil was associated with a higher cumulative redetachment rate (P<.001). There was no significant difference between the groups with respect to (1) change in visual acuity from preoperatively to 6 months postoperatively and (2) the proportion of patients who achieved ambulatory vision at each of the follow-up intervals investigated. Rates of elevated intraocular pressure, hypotony, corneal abnormality, cataract, and silicone oil emulsification were similar in the 2 groups. Conclusions: Anatomic and visual acuity outcomes, as well as complication rates, were similar in both groups; retinal reattachment and ambulatory vision were achieved in most eyes regardless of oil viscosity.