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Clinical Sciences |

Elevated Intraocular Pressure and Hypotony Following Silicone Oil Retinal Tamponade for Complex Retinal Detachment:  Incidence and Risk Factors FREE

Jeffrey D. Henderer, MD; Donald L. Budenz, MD; Harry W. Flynn Jr, MD; Joyce C. Schiffman, MS; William J. Feuer, MS; Timothy G. Murray, MD
[+] Author Affiliations

From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Fla.


Arch Ophthalmol. 1999;117(2):189-195. doi:10.1001/archopht.117.2.189.
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Objective  To evaluate the incidence of and risk factors for persistently elevated intraocular pressure (IOP) and hypotony in patients who have undergone pars plana vitrectomy with silicone oil injection for the management of complex retinal detachment.

Subjects and Methods  The medical records of 532 patients who underwent silicone oil injection for the management of complex retinal detachments between January 1, 1991, and December 31, 1996, at the Bascom Palmer Eye Institute, Miami, Fla, were reviewed. Elevated IOP was defined as elevated IOP requiring an operation at any time postoperatively or a persistently elevated IOP of greater than 25 mm Hg at or after the 6-month visit. Hypotony was defined as a persistent IOP of 5 mm Hg or less at or after the 6-month visit. Patients with transient perioperative IOP fluctuations were not counted.

Results  Survival analysis for patients without cytomegalovirus retinitis (n=383) revealed that 12.9% had an elevated IOP and 14.1% had hypotony by 6 months, 21% had an elevated IOP and 20.3% had hypotony by 1 year, and 29.5% had an elevated IOP and 27.3% had hypotony by 2 years. Among patients with cytomegalovirus retinitis (n=149), none had a persistently elevated IOP, 10% had hypotony by 6 months, and 5.9% had persistently elevated IOP and 10% developed chronic hypotony by 1 year. A history of glaucoma before silicone oil retinal tamponade (P=.03), diabetes mellitus (P=.02), and a high IOP on the first postoperative day (P=.006) were risk factors for elevated postoperative IOP in patients without cytomegalovirus retinitis. Risk factors for postoperative hypotony in patients without cytomegalovirus retinitis included preoperative hypotony (P<.001) and aphakia (P=.03).

Conclusions  An elevated or low IOP often develops postoperatively in patients without cytomegalovirus retinitis who undergo silicone oil injection for the management of complex retinal detachment. Risk factors for an elevated postoperative IOP include a history of glaucoma, diabetes mellitus, and a high IOP on the first postoperative day. Risk factors for hypotony include preoperative hypotony and aphakia.

Figures in this Article

INTRAVITREAL SILICONE oil is useful in the management of complex retinal detachments18 secondary to diabetes mellitus,916 giant retinal tear,1725 proliferative vitreoretinopathy,2640 trauma,4148 and cytomegalovirus (CMV) retinitis.4958 However, several complications, including the emulsification of oil,5963 cataract,2,4,62,63 keratopathy,60,6369 and problems with intraocular pressure (IOP) control60,63,64,7085 have been described. These events can occur at any time postoperatively and may range from mild and transient70,73 to severe pressure spikes resulting in loss of vision.84

Although the status of IOP after surgery with silicone oil has been documented previously,2,4,15,16,28,59,60,63,7073,76,8183,86 these series were often small and somewhat contradictory in their findings. In addition, changes in clinical practice, including the widespread use of an inferior peripheral iridectomy (PI), different surgical techniques and the purity of the oil, and the emergence of viral retinitis–induced detachments, make extrapolating data from older studies to current clinical practice difficult.

The present study was designed to assess the incidence and risk factors for persistently elevated IOP and hypotony in patients who have undergone pars plana vitrectomy with silicone oil injection for the management of complex retinal detachment.

After the study design was approved by the University of Miami School of Medicine, Miami, Fla, Human Subjects Committee (Protocol 96/61), we reviewed the medical records of all patients who underwent their first intravitreal injection of silicone oil for the management of a retinal detachment between January 1, 1991, and December 31, 1996, at the Bascom Palmer Eye Institute, Miami. Eyes that had a prior silicone oil injection and second eyes were excluded. All patients' medical records were retrospectively reviewed for preoperative, operative, and postoperative data. Information was collected from referring ophthalmologists for those patients no longer being seen at our institution.

All patients had a 3-port pars plana vitrectomy, retinopexy, and silicone oil instillation. The operating surgeon made the decision to use or not to use silicone oil. There was no defined protocol for selecting the use of silicone oil. Likewise, the surgeon decided to use or not to use a scleral buckle, lensectomy, or an inferior PI. An inferior PI was performed with a vitrectomy instrument if the surgeon deemed this appropriate. Because of the retrospective nature of the study, the size and patency of the inferior PI were not measured. Many patients had received a previous scleral buckle that was modified as needed. Silicone was either 1000 centistokes or 5000 centistokes, at the surgeon's discretion.

Two outcome variables were evaluated in this study. An elevated IOP was defined as an uncontrolled IOP requiring surgery at any time after silicone oil injection or a persistently elevated IOP (>25 mm Hg) at or after the 6-month visit. Hypotony, or a low IOP, was defined as an IOP of 5 mm Hg or less at or after the 6-month visit. Patients with transient, perioperative IOP fluctuations successfully treated with glaucoma medications were not considered to have elevated IOP.

The decision to treat and the choice of treatment of elevated IOP was made by the surgeon. Topical or oral medical therapy used included topical β-blockers, oral and topical carbonic anhydrase inhibitors, and nonselective α-agonists. Surgery was performed when medical therapy failed to control the IOP. Oil removal was usually not performed if there was persistent or recurrent retinal detachment. Trabeculectomy or glaucoma drainage tube implant was performed with or without oil removal.

To compare baseline characteristics and postoperative IOP changes between patients with CMV retinitis and those without CMV retinitis, the χ2 test or the Student t test was used as indicated. Patients with CMV retinitis were separated from those without CMV retinitis in risk factor analysis because patients with CMV retinitis did not have the outcome (elevated IOP) or the risk factors (such as diabetes mellitus or history of glaucoma being analyzed), and they had limited follow-up. For survival analysis of elevated IOP, the time from silicone oil surgery to an operation for a high IOP (such as trabeculectomy, glaucoma drainage tube placement, silicone oil removal, or cyclodestructive procedure) was used as the time to failure. For those patients who had a high IOP (>25 mm Hg) at or after the 6-month visit, the first visit at which the IOP was high, ie, the 6-month, 1-year, or 2-year visit, was used as the failure time. Similarly, for hypotony, the first time a low IOP (≤5 mm Hg) occurred at or after the 6-month visit was considered the failure time. Patients who underwent other ocular surgery, such as cataract extraction or a second retinal procedure, were censored at the time of this further surgery because this is a study of the effect of a first silicone oil retinal procedure on IOP. Survival rates for patients with and without a given risk factor were compared using a Kaplan-Meier survival analysis (log-rank test). For continuous variables, the Cox proportional hazards regression model was used.

A total of 532 eyes of 532 patients fit the study criteria and were included in the analysis. Baseline demographic and clinical characteristics are summarized in Table 1. The mean preoperative IOP for the patients with CMV retinitis (9.3 mm Hg) was significantly lower than for the patients without CMV retinitis (11.2 mm Hg) (P=.006).

Figure 1, A, presents the survival curve for elevated IOP by CMV retinitis status. The patients with CMV retinitis had a lower failure rate (ie, an operation required for IOP control at any time postoperatively or a persistent IOP of >25 mm Hg at or after the 6-month visit) than the patients without CMV retinitis (P=.001, log-rank test). The 6-month rate for the patients with CMV retinitis was 0% vs 12.9% for the patients without CMV retinitis; the 1-year rates were 5.9% and 21%, respectively. Treatment failed in only 1 patient with CMV retinitis who had a high IOP, 27 mm Hg, at 1 year postoperatively; no patient with CMV retinitis required an operation for IOP control. Among the patients without CMV retinitis, 55 had an elevated IOP. Twenty-seven patients without CMV retinitis underwent an operation for IOP control: 22 before 6 months, 2 between 6 months and 1 year, and 3 after 1 year. Twenty-eight patients had persistently elevated IOP: 14 at the 6-month visit, 11 at the 1-year visit, and 3 at the 2-year visit.

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Figure 1.

A, Cumulative proportion of patients who did not undergo an operation for elevated intraocular pressure (IOP) and who did not have an IOP greater than 25 mm Hg (P=.001), B, Cumulative proportion of patients who did not have an IOP of 5 mm Hg or lower (P=.26), by days after silicone oil surgery and by cytomegalovirus (CMV) retinitis status. Broken line indicates patients without CMV retinitis (n=383); solid line, patients with CMV retinitis (n=149).

Graphic Jump Location

The difference in rates of hypotony (IOP of ≤5 mm Hg at or after the 6-month visit) (Figure 1, B) was not statistically significant between the 2 groups (P=.26, log-rank test). Six patients with CMV retinitis vs 45 patients without CMV retinitis had hypotony at or after the 6-month postoperative visit. The 6-month rate for hypotony in the patients with CMV retinitis was 10% vs 14.1% for the patients without CMV retinitis; the 1-year rates were 10% and 20.3%, respectively. Too few patients with CMV retinitis were observed for 2 years to report their rates.

The mean (SD) rise in the IOP on the first postoperative day was less in the patients with CMV retinitis (9.5 [7.4] mm Hg, n=83) than in the patients without CMV retinitis (13.6 [12.8] mm Hg, n=231) (P=.006, Student t test). The rise in IOP from preoperative levels did not differ between the 2 groups at 1 week (6.1 vs 5.9 mm Hg), 1 month (3.1 vs 2.4 mm Hg), 3 months (1.5 vs 1.6 mm Hg), 6 months (1.1 vs 2.0 mm Hg), or 1 year (1.2 vs 3.1 mm Hg). Early perioperative IOP rises of greater than 25 mm Hg occurred in 12 (13.5%) of 89 patients with CMV retinitis at 1 day postoperatively, 16 (11.4%) of 140 patients within 1 week, and 17 (11.6%) of 146 patients within 1 month. The incidence among patients without CMV retinitis was 48.5% (115/237), 39.8% (145/364), and 40.3% (151/375), respectively. Perioperative hypotony (IOP ≤5 mm Hg) rates among patients with CMV retinitis were 1.1% (1/89) at 1 day, 3.6% (5/140) within 1 week, and 5.5% (8/146) within 1 month; among patients without CMV retinitis, the respective hypotony rates were 0.8% (2/237), 5.5% (20/364), and 14.4% (54/375).

The analysis of preoperative and intraoperative risk factors for increased IOP for patients without CMV retinitis is summarized in Table 2. Survival analysis revealed that a preoperative diagnosis of glaucoma (P=.03, log-rank test), diabetes mellitus (P=.02, log-rank test), and an IOP of 30 mm Hg or greater on the first postoperative day (P=.006, log-rank test) are significant risk factors for persistently elevated IOP. The survival curves for these 3 risk factors are presented in Figure 2 (A through C). For the patients with a history of glaucoma (n=23), the 6-month and 1-year success rates were 75.0% and 60.0%, respectively. For those without a glaucoma history (n=360), the 6-month, 1-year, and 2-year rates were 88.0%, 80.1%, and 71.5%, respectively; these rates are similar to those for the total population because few patients had a glaucoma history.

Table Graphic Jump LocationTable 2. Risk Factors for Elevated Intraocular Pressure (IOP) Among Patients Without Cytomegalovirus Retinitis
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Figure 2.

Among patients without cytomegalovirus retinitis, the cumulative proportion who did not undergo an operation for elevated intraocular pressure (IOP) and who did not have an IOP greater than 25 mm Hg, by days after silicone oil surgery, and, A, by history of glaucoma (broken line indicates patients with no history of glaucoma [n=360]; solid line, patients with a history of glaucoma [n=23]) (P=.03); B, by history of diabetes mellitus (broken line indicates patients with no history of diabetes [n=275]; solid line, patients with diabetes [n=108]) (P=.02); and C, by IOP on postoperative day 1 (broken line indicates patients with an IOP of <30 mm Hg [n=154]; solid line, patients with an IOP of ≥30 mm Hg [n=83]) (P=.006).

Graphic Jump Location

For the diabetic patients, a subgroup analysis of patients with proliferative diabetic retinopathy (PDR) alone (n=46), proliferative vitreoretinopathy (PVR) alone (n=28), both PDR and PVR (n=12), and neither PDR nor PVR (n=22) revealed that at 6 months, 68.5% of those with PDR alone, 100% with PVR alone, 56% with both PDR and PVR, and 83.4% with neither PDR nor PVR had a successfully controlled IOP. At 1 year, the IOP of 68.5% of patients with PDR, 92.3% of patients with PVR, 42% with both PDR and PVR, and 53.7% with neither PDR nor PVR was controlled. By 2 years, the IOP of 57.1% of those with PDR, 92.3% with PVR, 42% with both PDR and PVR, and 53.7% with neither PDR nor PVR was controlled. This was statistically significant for the group with PDR alone compared with the group with PVR alone (P=.007, log-rank test).

An analysis of risk factors for hypotony in patients without CMV retinitis is presented in Table 3. Survival analysis demonstrated that preoperative hypotony and aphakia are risk factors for postoperative hypotony (Figure 3, A and B). Among patients with hypotony, postoperative anterior PVR was present in 50% (3/6) of patients with CMV retinitis and in 77.5% (31/40) of patients without CMV retinitis. Recurrent posterior retinal detachments were present in 60.9% (28/46) of all patients with hypotony.

Table Graphic Jump LocationTable 3. Risk Factors for Hypotony Among Patients Without Cytomegalovirus Retinitis
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Figure 3.

Among patients without cytomegalovirus retinitis, the cumulative proportion who did not have an intraocular pressure (IOP) of 5 mm Hg or lower by days after silicone oil surgery and, A, by lens status (broken line indicates patients with aphakia [n=324]; solid line, patients with phakia [n=52]) (P=.03), and, B, by preoperative IOP (broken line indicates patients with a preoperative IOP of ≤5 mm Hg [n=82]; solid line, patients with a preoperative IOP of >5 mm Hg [n=281]) (P<.001).

Graphic Jump Location

An elevated IOP is a relatively common complication in eyes that have undergone pars plana vitrectomy with silicone oil injection for the management of complicated retinal detachment. First reported by Cibis,2 the rates of IOP elevation range from 2.2%70 to 56.0%,76 depending on the definition of elevated IOP and the time considered. The present study found, in patients without CMV retinitis, an incidence of elevated IOP of 12.9% at 6 months, 21% at 1 year, and 29.5% at 2 years.

An elevated IOP may occur by one of several mechanisms. These include acute pupillary block,63,8185,8789 emulsified oil in the angle,59,80,90 choroidal effusions with anterior displacement of the lens-iris diaphragm,8,63,74,76 peripheral anterior synechiae,76 and vitrectomy.91,92 In eyes without obvious pupillary block, the pressure rise is thought to be a mixture of mechanisms and may be related to the compromised state of eyes that require silicone oil injection.3,71,75,93

Several previous studies have addressed risk factors for elevated IOP after silicone oil injection. Nguyen et al74 found that eyes with preexisting pressure problems were more likely to have postoperative pressure problems. Burk et al75 found no correlation with a history of glaucoma. de Corral et al76 found that diabetes mellitus was not associated with pressure problems, but Ando16 found that diabetic patients with aphakia were likely to have a postoperative pressure rise. Silicone oil in the anterior chamber has been associated with a rise in the IOP,59,74,75,84,87 but normal pressures have been documented despite oil globules in the angle.60,62,74,81,82 An elevated IOP before emulsification has been demonstrated as well.3 In the present study, a history of glaucoma, diabetes mellitus, and high IOP on the first postoperative day were found to be risk factors for a persistently elevated IOP. Diabetic patients with isolated PDR detachments had a higher risk of an elevated IOP than those with isolated PVR detachments. A scleral buckle done either before or at the time of surgery was not shown to be significant for either an elevated IOP or hypotony. Petersen and Ritzau-Tondrow94 found that 1000 centistoke of oil was more likely than 5000 centistoke of oil to cause an elevated IOP, but in this study, there was no demonstrable difference.

Among patients with CMV retinitis, an elevated IOP after silicone oil injection has been shown to be rare.49 Our study found a similarly low incidence of 0% at 6 months and 5.9% at 1 year. The explanation for this is unclear. All of the patients with CMV retinitis in this study were positive for the human immunodeficiency virus (HIV). Patients infected with HIV have a lower preoperative IOP in general than HIV-negative patients.95 In this series, the group with CMV retinitis had a lower preoperative IOP, and the rise in IOP on the first postoperative day was also less than in patients without CMV retinitis. One possible explanation is the lack of inflammatory response from the compromised immune system of HIV-positive patients. Likewise, the mechanism of detachments in patients with CMV retinitis is different from that in patients without CMV retinitis. Detachments in patients with CMV retinitis are associated with necrotic retinal holes, whereas in patients without CMV retinitis, they are the result of posterior vitreous detachments. Therefore, patients with CMV retinitis who have detachments are at a lower risk of anterior PVR and thus may have a lower risk of postoperative persistent IOP abnormalities. Surgical technique, which was not controlled or evaluated in this study, may also play a role.

In this study, the presence of a PI did not appear to protect against an IOP rise higher than 25 mm Hg at any point in the postoperative period and, in fact, may have been a risk factor for hypotony (P=.07). An inferior PI, as first proposed by Ando in 1985,83 theoretically allows aqueous to pass between the posterior and anterior chambers underneath the oil and thereby prevents pupillary block in patients with aphakia and those with pseudophakia. This has been shown not only to work in the short term84,87 but also to reduce anterior segment and pressure complications over the long term.64,88 A superior PI also has been effective in eyes that undergo intracapsular cataract extraction after silicone oil injection.89 The major reason for PI failure is closure due either to inflammation,8,96 especially in diabetic patients, or to oil block.88 Because of the retrospective nature of this study, we were unable to accurately assess the patency of the PI. One other study, by Lucke et al,93 also showed that the incidence of IOP elevation was unaffected by the presence of an inferior PI.

Hypotony has been a substantial problem in eyes undergoing repair of complex retinal detachment with silicone oil. Preoperative and postoperative anterior PVR has been shown to be a risk factor for poor anatomic outcome9799 and a higher incidence of hypotony.100,101 In our patients in whom hypotony developed, we noted a high incidence of anterior PVR (77.5%) and a significant incidence of recurrent posterior retinal detachment. These results are similar to those in the Silicone Study,101 suggesting that a factor for the development of hypotony in patients undergoing repair of a complex retinal detachment with silicone oil may be the development of anterior PVR or posterior recurrent retinal detachment.

Twenty-one percent of patients without CMV retinitis by 1 year and 29.5% by 2 years who receive silicone oil for the management of complex retinal detachment may develop persistently elevated IOP (>25 mm Hg) or require surgery for IOP. In patients without CMV retinitis, hypotony develops in 22% by 1 year and 27.3% by 2 years. Survival analysis of elevated postoperative pressures in patients without CMV retinitis identified a history of glaucoma, diabetes mellitus, and high IOP on the first postoperative day as risk factors. Risk factors for hypotony included the presence of preoperative hypotony and of aphakia.

Accepted for publication September 15, 1998.

This study was supported in part by an unrestricted grant from Research to Prevent Blindness Inc, New York, NY, and by grant EY10900 from the Public Health Service, US Department of Health and Human Services, Bethesda, Md.

Corresponding author: Donald L. Budenz, MD, Bascom Palmer Eye Institute, PO Box 016880, Miami, FL 33101 (e-mail: dbudenz@bpei.med.miami.edu).

Cibis  PABecker  BOkun  ECanaan  S The use of liquid silicone in retinal detachment surgery. Arch Ophthalmol. 1962;68590- 599
Cibis  PA Recent methods in the surgical treatment of retinal detachment:intravitreal procedures. Trans Ophthalmol Soc U K. 1965;85111- 127
Watzke  RC Silicone retinopiesis for retinal detachment: a long-term clinical evaluation. Arch Ophthalmol. 1967;77185- 196
Okun  E Intravitreal surgery utilizing liquid silicone: a long term followup. Trans Pac Coast Oto-ophthalmol Soc Annu Meet. 1968;52141- 159
Kanski  JJDaniel  R Intravitreal silicone injection in retinal detachment. Br J Ophthalmol. 1973;57542- 545
Azen  SPScott  IUFlynn  HW  Jr  et al.  Silicone oil in the repair of complex retinal detachments: a prospective observational multicenter study. Ophthalmology. 1998;1051587- 1597
Capone  A  JrAaberg  TM Silicone oil in vitreoretinal surgery. Curr Opin Ophthalmol. 1995;633- 37
Lean  JS Use of silicone oil as an additional technique in vitreoretinal surgery. Ryan  SJGlaser  BMMichels  RGedsRetina. Vol 3 St Louis, Mo Mosby1994;2151- 2164
Sima  PZoran  T Long-term results of vitreous surgery for proliferative diabetic retinopathy. Doc Ophthalmol. 1994;87223- 232
Karel  IKalvodova  B Long-term results of pars plana vitrectomy and silicone oil for complications of diabetic retinopathy. Eur J Ophthalmol. 1994;452- 58
Mathis  APagot  VDavid  JL The use of perfluorodecalin in diabetic vitrectomy. Fortschr Ophthalmol. 1991;88148- 150
Gabel  VPBeck  P Does silicone oil improve the prognosis of severe proliferative diabetic retinopathy? Klin Monatsbl Augenheilkd. 1990;197112- 117
Brourman  NDBlumenkranz  MSCox  MSTrese  MT Silicone oil for the treatment of severe proliferative diabetic retinopathy. Ophthalmology. 1989;96759- 764
Yeo  JHGlaser  BMMichels  RG Silicone oil in the treatment of complicated retinal detachments. Ophthalmology. 1987;941109- 1113
Laqua  HLucke  KFoerster  M Results of silicone oil surgery. Jpn J Ophthalmol. 1987;31124- 131
Ando  F Usefulness and limit of silicone in management of complicated retinal detachment. Jpn J Ophthalmol. 1987;31138- 146
Karel  IMichalickova  MSoucek  P Long-term results of pars plana vitrectomy and silicone oil for giant tears. Eur J Ophthalmol. 1996;6315- 321
Leaver  PK Vitrectomy and fluid/silicone oil exchange for giant retinal tears: 10-year follow-up. Ger J Ophthalmol. 1993;220- 23
Aylward  GWCooling  RJLeaver  PK Trauma-induced retinal detachment associated with giant retinal tears. Retina. 1993;13136- 141
Mathis  APagot  VGazagne  CMalecaze  F Giant retinal tears: surgical techniques and results using perfluorodecalin and silicone oil tamponade. Retina. 1992;12(suppl)S7- S10
Kreiger  AELewis  H Management of giant retinal tears without scleral buckling: use of radical dissection of the vitreous base and perfluoro-octane and intraocular tamponade. Ophthalmology. 1992;99491- 497
Camacho  HBajaire  BMejia  LF Silicone oil in the management of giant retinal tears. Ann Ophthalmol. 1992;2445- 49
Le Mer  YKroll  P Use of liquid perfluorocarbon in giant tears: initial results [in German]. Klin Monatsbl Augenheilkd. 1991;198264- 267
Karel  IKalvodova  BDotrelova  DBedrich  P Pars plana vitrectomy with implantation of silicone oil in surgery for very large retinal tears [in Czech]. Cesk Oftalmol. 1989;45420- 427
Leaver  PKBillington  BM Vitrectomy and fluid/silicone oil exchange for giant retinal tears: 5 years follow-up. Graefes Arch Clin Exp Ophthalmol. 1989;227323- 327
Glaser  BM Treatment of giant retinal tears combined with proliferative vitreoretinopathy. Ophthalmology. 1986;931193- 1197
Abrams  GWAzen  SPMcCuen  BW  IIFlynn  HW  JrLai  MYRyan  SJ Vitrectomy with silicone oil or long-acting gas in eyes with severe proliferative vitreoretinopathy: results of additional and long-term follow-up: Silicon Study Report 11. Arch Ophthalmol. 1997;115335- 344
Fisk  MJCairns  JD Silicone oil insertion: a review of 127 consecutive cases. Aust N Z J Ophthalmol. 1995;2325- 32
Korner  FBohnke  M Vitrectomy in proliferative vitreoretinopathy: anatomical and functional results in 501 patients. Klin Monatsbl Augenheilkd. 1995;206239- 245
Van Meurs  JCMertens  DAPeperkamp  EPost  J Five-year results of vitrectomy and silicone oil in patients with proliferative vitreoretinopathy. Retina. 1993;13285- 289
Zauberman  HHemo  I Silicone oil tamponade for retinal detachment and delayed treatment of retinal tears. Ophthalmic Surg. 1993;24600- 603
Blumenkranz  MSAzen  SPAaberg  T  et al.  Relaxing retinotomy with silicone oil or long-acting gas in eyes with severe proliferative vitreoretinopathy: Silicone Study Report 5: the Silicone Study Group. Am J Ophthalmol. 1993;116557- 564
McCuen  BW  IIAzen  SPStern  W  et al.  Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe proliferative vitreoretinopathy: Silicone Study Report 3. Retina. 1993;13279- 284
Silicone Study Group, Vitrectomy with silicone oil or sulfur hexafluoride gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial: Silicone Study Report 1. Arch Ophthalmol. 1992;110770- 779
Silicone Study Group, Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial: Silicone Study Report 2. Arch Ophthalmol. 1992;110780- 792
Sell  CHMcCuen  BW  IILanders  MB  IIIMachemer  R Long-term results of successful vitrectomy with silicone oil for advanced proliferative vitreoretinopathy. Am J Ophthalmol. 1987;10324- 28
Stern  WHJohnson  RNIrvine  AR  et al.  Extended retinal tamponade in the treatment of retinal detachment with proliferative vitreoretinopathy. Br J Ophthalmol. 1986;70911- 917
Rinkoff  JSde Juan  E  JrMcCuen  BW  II Silicone oil for retinal detachment with advanced proliferative vitreoretinopathy following failed vitrectomy for proliferative diabetic retinopathy. Am J Ophthalmol. 1986;101181- 186
McCuen  BW  IILanders  MB  IIIMachemer  R The use of silicone oil following failed vitrectomy for retinal detachment with advanced proliferative vitreoretinopathy. Ophthalmology. 1985;921029- 1034
Gonvers  M Temporary silicone oil tamponade in the management of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol. 1985;100239- 245
Claes  CZivojnovic  R Treatment of posterior eye segment complications after perforating trauma. Bull Soc Belge Ophtalmol. 1992;24561- 63
Liggett  PEMani  NGreen  RECano  MRyan  SJLean  JS Management of traumatic rupture of the globe in aphakic patients. Retina. 1990;10(suppl)S59- S64
Alexandridis  E Silicone oil tamponade in the management of severe hemorrhagic detachment of the choroid and ciliary body after surgical trauma. Ophthalmologica. 1990;200189- 193
Stucchi  CAVignanelli  M Early vitrectomy in the treatment of severe eye injuries. Klin Monatsbl Augenheilkd. 1990;196346- 350
Autoszyk  ANMcCuen  BW  IIde Juan  E  JrMachemer  R Silicone oil injection after failed primary vitreous surgery in severe ocular trauma. Am J Ophthalmol. 1989;107537- 543
Skorpik  CMenapace  RGnad  HDParoussis  P Silicone oil implantation in penetrating injuries complicated by PVR: results from 1982 to 1986. Retina. 1989;98- 14
Lemmen  KDHeimann  K Early vitrectomy with primary silicone oil injection in very severely injured eyes. Klin Monatsbl Augenheilkd. 1988;193594- 601
Miyake  YAndo  F Surgical results of vitrectomy in ocular trauma. Retina. 1983;3265- 268
Davis  JLSerfass  MSLai  MYTrask  DKAzen  SP Silicone oil in repair of retinal detachments caused by necrotizing retinitis in HIV infection. Arch Ophthalmol. 1995;1131401- 1409
Irvine  ARLonn  LSchwartz  DZarbin  MBallesteros  FKroll  S Retinal detachment in AIDS: long-term results after repair with silicone oil. Br J Ophthalmol. 1997;81180- 183
Garcia  RFFlores-Aguilar  MQuiceno  JI  et al.  Results of rhegmatogenous retinal detachment repair in cytomegalovirus retinitis with and without scleral buckling. Ophthalmology. 1995;102236- 245
Geier  SAKlauss  VBogner  JRSchmidt-Kittler  HSadri  IGoebel  FD Retinal detachment in patients with acquired immunodeficiency syndrome. Ger J Ophthalmol. 1994;39- 14
Lim  JIEnger  CHaller  JA  et al.  Improved visual results after surgical repair of cytomegalovirus-related retinal detachments. Ophthalmology. 1994;101264- 269
Chuang  ELDavis  JL Management of retinal detachment associated with CMV retinitis in AIDS patients. Eye. 1992;628- 34
Freeman  WRQuiceno  JICrapotta  JAListhaus  AMunguia  DAguilar  MF Surgical repair of rhegmatogenous retinal detachment in immunosuppressed patients with cytomegalovirus retinitis. Ophthalmology. 1992;99466- 474
Regillo  CDVander  JFDuker  JSFischer  DHBelmont  JBKleiner  R Repair of retinitis-related retinal detachments with silicone oil in patients with acquired immunodeficiency syndrome. Am J Ophthalmol. 1992;11321- 27
Dugel  PULiggett  PELee  MB  et al.  Repair of retinal detachment caused by cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome. Am J Ophthalmol. 1991;112235- 242
Jabs  DAEnger  CHaller  Jde Bustros  S Retinal detachments in patients with cytomegalovirus retinitis. Arch Ophthalmol. 1991;109794- 799
Valone  J  JrMcCarthy  M Emulsified anterior chamber silicone oil and glaucoma. Ophthalmology. 1994;1011908- 1912
Federman  JLSchubert  HD Complications associated with the use of silicone oil in 150 eyes after retina-vitreous surgery. Ophthalmology. 1988;95870- 876
Crisp  Ade Juan  E  JrTiedeman  J Effects of silicone oil viscosity on emulsification. Arch Ophthalmol. 1987;105546- 550
Laroche  LPavlakis  CSaraux  HOrcel  L Ocular findings following intravitreal silicone injection. Arch Ophthalmol. 1983;1011422- 1425
McCuen  BW  IIde Juan  E  JrLanders  MB  IIIMachemer  R Silicone oil in vitreoretinal surgery, II: results and complications. Retina. 1985;5198- 205
Beekhuis  WHAndo  FZivojnovic  RMertens  DAEPeperkamp  E Basal iridectomy at 6 o'clock in the aphakic eye treated with silicone oil: prevention of keratopathy and secondary glaucoma. Br J Ophthalmol. 1987;71197- 200
Abrams  GWAzen  SPBarr  CC  et al.  The incidence of corneal abnormalities in the Silicone Study: Silicone Study Report 7. Arch Ophthalmol. 1995;113764- 769
Didier  TBrasseur  GCharlin  JF Retinal detachment with vitreoretinal proliferation treated by temporary silicone oil tamponade: long-term results [in French]. Bull Soc Ophtalmol Fr. 1990;90181- 182185
Lemmen  KDDimopoulos  SKirchof  BHeimann  K Keratopathy following pars plana vitrectomy with silicone oil filling. Dev Ophthalmol. 1987;1388- 98
Pang  MPPeyman  GAKao  GW Early anterior segment complications after silicone oil injection. Can J Ophthalmol. 1986;21271- 275
Chauvaud  DBarthelemy  FFrota  A Use of silicone oil for temporary tamponade in the treatment of retinal detachment with vitreoretinal retraction, II: aspects, prevention and treatment of complications [in French]. J Fr Ophtalmol. 1984;7279- 284
Unosson  KStenkula  STornqvist  PWeijdegard  L Liquid silicone in the treatment of retinal detachment. Acta Ophthalmol (Copenh). 1985;63656- 660
Punnonen  ELaatikainen  LRuusuvaara  PSetala  K Silicone oil in retinal detachment surgery: results and complications. Acta Ophthalmol (Copenh). 1989;6730- 36
Riedel  KGGabel  VPNeubauer  LKampik  ALund  OE Intravitreal silicone oil injection: complications and treatment of 415 consecutive patients. Graefes Arch Clin Exp Ophthalmol. 1990;22819- 23
Barr  CCLai  MYLean  JS  et al.  Postoperative intraocular pressure abnormalities in the Silicone Study: Silicone Study Report 4. Ophthalmology. 1993;1001629- 1635
Nguyen  QHLloyd  MAHeuer  DK  et al.  Incidence and management of glaucoma after intravitreal silicone oil injection for complicated retinal detachments. Ophthalmology. 1992;991520- 1526
Burk  LLShields  MBProia  ADMcCuen  BW  II Intraocular pressure following intravitreal silicone oil injection. Ophthalmic Surg. 1988;19565- 569
de Corral  LRCohen  SBPeyman  GA Effect of intravitreal silicone oil on intraocular pressure. Ophthalmic Surg. 1987;18446- 449
Ehud  AVarda  CJoseph  MGiora  T Management of complicated retinal detachment by vitrectomy and silicone oil injection. Metab Pediatr Syst Ophthalmol. 1988;1163- 66
Leaver  PK Complications of intraocular silicone oil. Ryan  SJGlaser  BMedsRetina. Vol 32nd ed. St Louis, Mo Mosby Year Book Inc1994;2165- 2179
Roussat  BRuellan  YM Treatment of retinal detachment by vitrectomy and injection of silicone oil: long-term results and complications in 105 cases [in French]. J Fr Ophtalmol. 1984;711- 18
Nowack  CLucke  KLaqua  H Removal of silicone oil in treatment of so-called emulsification glaucoma [in German]. Ophthalmologe. 1992;89462- 464
Leaver  PKGrey  RHGarner  A Silicone oil injection in the treatment of massive preretinal retraction, II: late complications in 93 eyes. Br J Ophthalmol. 1979;63361- 367
Leaver  PKGrey  RHGarner  A Complications following silicone-oil injection. Mod Probl Ophthalmol. 1979;20290- 294
Ando  F Intraocular hypertension resulting from pupillary block by silicone oil. Am J Ophthalmol. 1985;9987- 88
Zborowski-Gutman  LTreister  GNaveh  NChen  VBlumenthal  M Acute glaucoma following vitrectomy and silicone oil injection. Br J Ophthalmol. 1987;71903- 906
Haut  JUllern  MChermet  MVan Effenterre  G Complications of intraocular injections of silicone combined with vitrectomy. Ophthalmologica. 1980;18029- 35
Chan  COkun  E The question of ocular tolerance to intravitreal liquid silicone. Ophthalmology. 1986;93651- 660
Bartov  EHuna  RAshkenazi  I  et al.  Identification, prevention, and treatment of silicone oil pupillary block after an inferior iridectomy. Am J Ophthalmol. 1991;111501- 504
Laganowski  HCLeaver  PK Silicone oil in the aphakic eye: the influence of a six o'clock peripheral iridectomy. Eye. 1989;3338- 348
Elliott  AJBacon  ASScott  JD The superior peripheral iridectomy: prevention of pupil block due to silicone oil. Eye. 1990;4 ((pt 1)) 226- 229
Moisseiev  JBarak  AManaim  TTreister  G Removal of silicone oil in the management of glaucoma in eyes with emulsified silicone. Retina. 1993;13290- 295
Han  DPLewis  HLambrou  FH  JrMieler  WFHartz  A Mechanisms of intraocular pressure elevation after pars plana vitrectomy. Ophthalmology. 1989;961357- 1362
Weinberg  RSPeyman  GAHuamonte  FU Elevation of intraocular pressure after pars plana vitrectomy. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1976;200157- 161
Lucke  KStrobel  BFoerster  MLaqua  H Secondary glaucoma after silicone oil surgery [in German]. Klin Monatsbl Augenheilkd. 1990;196205- 209
Petersen  JRitzau-Tondrow  U Chronic glaucoma following silicone oil implantation: a comparison of two oils of differing viscosity. Fortschr Ophthalmol. 1988;85632- 634
Arevalo  JFMunguia  DFaber  D  et al.  Correlation between intraocular pressure and CD4+ T-lymphocyte counts in patients with human immunodeficiency virus with and without cytomegalovirus retinitis. Am J Ophthalmol. 1996;12291- 96
Madreperla  SAMcCuen  BW  II Inferior peripheral iridectomy in patients receiving silicone oil: rates of postoperative closure and effect on oil position. Retina. 1995;1587- 90
Lewis  HAaberg  T Anterior proliferative vitreoretinopathy. Am J Ophthalmol. 1988;105277- 284
Lewis  HAaberg  TAbrams  G Causes of failure after initial vitreoretinal surgery for severe proliferative vitreoretinopathy. Am J Ophthalmol. 1991;1118- 14
Lewis  HAaberg  T Causes of failure after repeat vitreoretinal surgery for recurrent proliferative vitreoretinopathy. Am J Ophthalmol. 1991;11115- 19
Lewis  HVerdaguer  J Surgical treatment for chronic hypotony and anterior proliferative vitreoretinopathy. Am J Ophthalmol. 1996;122228- 235
Diddie  KRAzen  SPFreeman  HM  et al.  Anterior proliferative vitreoretinopathy in the silicone study: Silicone Study Report Number 10. Ophthalmology. 1996;1031092- 1099

Figures

Place holder to copy figure label and caption
Figure 1.

A, Cumulative proportion of patients who did not undergo an operation for elevated intraocular pressure (IOP) and who did not have an IOP greater than 25 mm Hg (P=.001), B, Cumulative proportion of patients who did not have an IOP of 5 mm Hg or lower (P=.26), by days after silicone oil surgery and by cytomegalovirus (CMV) retinitis status. Broken line indicates patients without CMV retinitis (n=383); solid line, patients with CMV retinitis (n=149).

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Among patients without cytomegalovirus retinitis, the cumulative proportion who did not undergo an operation for elevated intraocular pressure (IOP) and who did not have an IOP greater than 25 mm Hg, by days after silicone oil surgery, and, A, by history of glaucoma (broken line indicates patients with no history of glaucoma [n=360]; solid line, patients with a history of glaucoma [n=23]) (P=.03); B, by history of diabetes mellitus (broken line indicates patients with no history of diabetes [n=275]; solid line, patients with diabetes [n=108]) (P=.02); and C, by IOP on postoperative day 1 (broken line indicates patients with an IOP of <30 mm Hg [n=154]; solid line, patients with an IOP of ≥30 mm Hg [n=83]) (P=.006).

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

Among patients without cytomegalovirus retinitis, the cumulative proportion who did not have an intraocular pressure (IOP) of 5 mm Hg or lower by days after silicone oil surgery and, A, by lens status (broken line indicates patients with aphakia [n=324]; solid line, patients with phakia [n=52]) (P=.03), and, B, by preoperative IOP (broken line indicates patients with a preoperative IOP of ≤5 mm Hg [n=82]; solid line, patients with a preoperative IOP of >5 mm Hg [n=281]) (P<.001).

Graphic Jump Location

Tables

Table Graphic Jump LocationTable 2. Risk Factors for Elevated Intraocular Pressure (IOP) Among Patients Without Cytomegalovirus Retinitis
Table Graphic Jump LocationTable 3. Risk Factors for Hypotony Among Patients Without Cytomegalovirus Retinitis

References

Cibis  PABecker  BOkun  ECanaan  S The use of liquid silicone in retinal detachment surgery. Arch Ophthalmol. 1962;68590- 599
Cibis  PA Recent methods in the surgical treatment of retinal detachment:intravitreal procedures. Trans Ophthalmol Soc U K. 1965;85111- 127
Watzke  RC Silicone retinopiesis for retinal detachment: a long-term clinical evaluation. Arch Ophthalmol. 1967;77185- 196
Okun  E Intravitreal surgery utilizing liquid silicone: a long term followup. Trans Pac Coast Oto-ophthalmol Soc Annu Meet. 1968;52141- 159
Kanski  JJDaniel  R Intravitreal silicone injection in retinal detachment. Br J Ophthalmol. 1973;57542- 545
Azen  SPScott  IUFlynn  HW  Jr  et al.  Silicone oil in the repair of complex retinal detachments: a prospective observational multicenter study. Ophthalmology. 1998;1051587- 1597
Capone  A  JrAaberg  TM Silicone oil in vitreoretinal surgery. Curr Opin Ophthalmol. 1995;633- 37
Lean  JS Use of silicone oil as an additional technique in vitreoretinal surgery. Ryan  SJGlaser  BMMichels  RGedsRetina. Vol 3 St Louis, Mo Mosby1994;2151- 2164
Sima  PZoran  T Long-term results of vitreous surgery for proliferative diabetic retinopathy. Doc Ophthalmol. 1994;87223- 232
Karel  IKalvodova  B Long-term results of pars plana vitrectomy and silicone oil for complications of diabetic retinopathy. Eur J Ophthalmol. 1994;452- 58
Mathis  APagot  VDavid  JL The use of perfluorodecalin in diabetic vitrectomy. Fortschr Ophthalmol. 1991;88148- 150
Gabel  VPBeck  P Does silicone oil improve the prognosis of severe proliferative diabetic retinopathy? Klin Monatsbl Augenheilkd. 1990;197112- 117
Brourman  NDBlumenkranz  MSCox  MSTrese  MT Silicone oil for the treatment of severe proliferative diabetic retinopathy. Ophthalmology. 1989;96759- 764
Yeo  JHGlaser  BMMichels  RG Silicone oil in the treatment of complicated retinal detachments. Ophthalmology. 1987;941109- 1113
Laqua  HLucke  KFoerster  M Results of silicone oil surgery. Jpn J Ophthalmol. 1987;31124- 131
Ando  F Usefulness and limit of silicone in management of complicated retinal detachment. Jpn J Ophthalmol. 1987;31138- 146
Karel  IMichalickova  MSoucek  P Long-term results of pars plana vitrectomy and silicone oil for giant tears. Eur J Ophthalmol. 1996;6315- 321
Leaver  PK Vitrectomy and fluid/silicone oil exchange for giant retinal tears: 10-year follow-up. Ger J Ophthalmol. 1993;220- 23
Aylward  GWCooling  RJLeaver  PK Trauma-induced retinal detachment associated with giant retinal tears. Retina. 1993;13136- 141
Mathis  APagot  VGazagne  CMalecaze  F Giant retinal tears: surgical techniques and results using perfluorodecalin and silicone oil tamponade. Retina. 1992;12(suppl)S7- S10
Kreiger  AELewis  H Management of giant retinal tears without scleral buckling: use of radical dissection of the vitreous base and perfluoro-octane and intraocular tamponade. Ophthalmology. 1992;99491- 497
Camacho  HBajaire  BMejia  LF Silicone oil in the management of giant retinal tears. Ann Ophthalmol. 1992;2445- 49
Le Mer  YKroll  P Use of liquid perfluorocarbon in giant tears: initial results [in German]. Klin Monatsbl Augenheilkd. 1991;198264- 267
Karel  IKalvodova  BDotrelova  DBedrich  P Pars plana vitrectomy with implantation of silicone oil in surgery for very large retinal tears [in Czech]. Cesk Oftalmol. 1989;45420- 427
Leaver  PKBillington  BM Vitrectomy and fluid/silicone oil exchange for giant retinal tears: 5 years follow-up. Graefes Arch Clin Exp Ophthalmol. 1989;227323- 327
Glaser  BM Treatment of giant retinal tears combined with proliferative vitreoretinopathy. Ophthalmology. 1986;931193- 1197
Abrams  GWAzen  SPMcCuen  BW  IIFlynn  HW  JrLai  MYRyan  SJ Vitrectomy with silicone oil or long-acting gas in eyes with severe proliferative vitreoretinopathy: results of additional and long-term follow-up: Silicon Study Report 11. Arch Ophthalmol. 1997;115335- 344
Fisk  MJCairns  JD Silicone oil insertion: a review of 127 consecutive cases. Aust N Z J Ophthalmol. 1995;2325- 32
Korner  FBohnke  M Vitrectomy in proliferative vitreoretinopathy: anatomical and functional results in 501 patients. Klin Monatsbl Augenheilkd. 1995;206239- 245
Van Meurs  JCMertens  DAPeperkamp  EPost  J Five-year results of vitrectomy and silicone oil in patients with proliferative vitreoretinopathy. Retina. 1993;13285- 289
Zauberman  HHemo  I Silicone oil tamponade for retinal detachment and delayed treatment of retinal tears. Ophthalmic Surg. 1993;24600- 603
Blumenkranz  MSAzen  SPAaberg  T  et al.  Relaxing retinotomy with silicone oil or long-acting gas in eyes with severe proliferative vitreoretinopathy: Silicone Study Report 5: the Silicone Study Group. Am J Ophthalmol. 1993;116557- 564
McCuen  BW  IIAzen  SPStern  W  et al.  Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe proliferative vitreoretinopathy: Silicone Study Report 3. Retina. 1993;13279- 284
Silicone Study Group, Vitrectomy with silicone oil or sulfur hexafluoride gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial: Silicone Study Report 1. Arch Ophthalmol. 1992;110770- 779
Silicone Study Group, Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial: Silicone Study Report 2. Arch Ophthalmol. 1992;110780- 792
Sell  CHMcCuen  BW  IILanders  MB  IIIMachemer  R Long-term results of successful vitrectomy with silicone oil for advanced proliferative vitreoretinopathy. Am J Ophthalmol. 1987;10324- 28
Stern  WHJohnson  RNIrvine  AR  et al.  Extended retinal tamponade in the treatment of retinal detachment with proliferative vitreoretinopathy. Br J Ophthalmol. 1986;70911- 917
Rinkoff  JSde Juan  E  JrMcCuen  BW  II Silicone oil for retinal detachment with advanced proliferative vitreoretinopathy following failed vitrectomy for proliferative diabetic retinopathy. Am J Ophthalmol. 1986;101181- 186
McCuen  BW  IILanders  MB  IIIMachemer  R The use of silicone oil following failed vitrectomy for retinal detachment with advanced proliferative vitreoretinopathy. Ophthalmology. 1985;921029- 1034
Gonvers  M Temporary silicone oil tamponade in the management of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol. 1985;100239- 245
Claes  CZivojnovic  R Treatment of posterior eye segment complications after perforating trauma. Bull Soc Belge Ophtalmol. 1992;24561- 63
Liggett  PEMani  NGreen  RECano  MRyan  SJLean  JS Management of traumatic rupture of the globe in aphakic patients. Retina. 1990;10(suppl)S59- S64
Alexandridis  E Silicone oil tamponade in the management of severe hemorrhagic detachment of the choroid and ciliary body after surgical trauma. Ophthalmologica. 1990;200189- 193
Stucchi  CAVignanelli  M Early vitrectomy in the treatment of severe eye injuries. Klin Monatsbl Augenheilkd. 1990;196346- 350
Autoszyk  ANMcCuen  BW  IIde Juan  E  JrMachemer  R Silicone oil injection after failed primary vitreous surgery in severe ocular trauma. Am J Ophthalmol. 1989;107537- 543
Skorpik  CMenapace  RGnad  HDParoussis  P Silicone oil implantation in penetrating injuries complicated by PVR: results from 1982 to 1986. Retina. 1989;98- 14
Lemmen  KDHeimann  K Early vitrectomy with primary silicone oil injection in very severely injured eyes. Klin Monatsbl Augenheilkd. 1988;193594- 601
Miyake  YAndo  F Surgical results of vitrectomy in ocular trauma. Retina. 1983;3265- 268
Davis  JLSerfass  MSLai  MYTrask  DKAzen  SP Silicone oil in repair of retinal detachments caused by necrotizing retinitis in HIV infection. Arch Ophthalmol. 1995;1131401- 1409
Irvine  ARLonn  LSchwartz  DZarbin  MBallesteros  FKroll  S Retinal detachment in AIDS: long-term results after repair with silicone oil. Br J Ophthalmol. 1997;81180- 183
Garcia  RFFlores-Aguilar  MQuiceno  JI  et al.  Results of rhegmatogenous retinal detachment repair in cytomegalovirus retinitis with and without scleral buckling. Ophthalmology. 1995;102236- 245
Geier  SAKlauss  VBogner  JRSchmidt-Kittler  HSadri  IGoebel  FD Retinal detachment in patients with acquired immunodeficiency syndrome. Ger J Ophthalmol. 1994;39- 14
Lim  JIEnger  CHaller  JA  et al.  Improved visual results after surgical repair of cytomegalovirus-related retinal detachments. Ophthalmology. 1994;101264- 269
Chuang  ELDavis  JL Management of retinal detachment associated with CMV retinitis in AIDS patients. Eye. 1992;628- 34
Freeman  WRQuiceno  JICrapotta  JAListhaus  AMunguia  DAguilar  MF Surgical repair of rhegmatogenous retinal detachment in immunosuppressed patients with cytomegalovirus retinitis. Ophthalmology. 1992;99466- 474
Regillo  CDVander  JFDuker  JSFischer  DHBelmont  JBKleiner  R Repair of retinitis-related retinal detachments with silicone oil in patients with acquired immunodeficiency syndrome. Am J Ophthalmol. 1992;11321- 27
Dugel  PULiggett  PELee  MB  et al.  Repair of retinal detachment caused by cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome. Am J Ophthalmol. 1991;112235- 242
Jabs  DAEnger  CHaller  Jde Bustros  S Retinal detachments in patients with cytomegalovirus retinitis. Arch Ophthalmol. 1991;109794- 799
Valone  J  JrMcCarthy  M Emulsified anterior chamber silicone oil and glaucoma. Ophthalmology. 1994;1011908- 1912
Federman  JLSchubert  HD Complications associated with the use of silicone oil in 150 eyes after retina-vitreous surgery. Ophthalmology. 1988;95870- 876
Crisp  Ade Juan  E  JrTiedeman  J Effects of silicone oil viscosity on emulsification. Arch Ophthalmol. 1987;105546- 550
Laroche  LPavlakis  CSaraux  HOrcel  L Ocular findings following intravitreal silicone injection. Arch Ophthalmol. 1983;1011422- 1425
McCuen  BW  IIde Juan  E  JrLanders  MB  IIIMachemer  R Silicone oil in vitreoretinal surgery, II: results and complications. Retina. 1985;5198- 205
Beekhuis  WHAndo  FZivojnovic  RMertens  DAEPeperkamp  E Basal iridectomy at 6 o'clock in the aphakic eye treated with silicone oil: prevention of keratopathy and secondary glaucoma. Br J Ophthalmol. 1987;71197- 200
Abrams  GWAzen  SPBarr  CC  et al.  The incidence of corneal abnormalities in the Silicone Study: Silicone Study Report 7. Arch Ophthalmol. 1995;113764- 769
Didier  TBrasseur  GCharlin  JF Retinal detachment with vitreoretinal proliferation treated by temporary silicone oil tamponade: long-term results [in French]. Bull Soc Ophtalmol Fr. 1990;90181- 182185
Lemmen  KDDimopoulos  SKirchof  BHeimann  K Keratopathy following pars plana vitrectomy with silicone oil filling. Dev Ophthalmol. 1987;1388- 98
Pang  MPPeyman  GAKao  GW Early anterior segment complications after silicone oil injection. Can J Ophthalmol. 1986;21271- 275
Chauvaud  DBarthelemy  FFrota  A Use of silicone oil for temporary tamponade in the treatment of retinal detachment with vitreoretinal retraction, II: aspects, prevention and treatment of complications [in French]. J Fr Ophtalmol. 1984;7279- 284
Unosson  KStenkula  STornqvist  PWeijdegard  L Liquid silicone in the treatment of retinal detachment. Acta Ophthalmol (Copenh). 1985;63656- 660
Punnonen  ELaatikainen  LRuusuvaara  PSetala  K Silicone oil in retinal detachment surgery: results and complications. Acta Ophthalmol (Copenh). 1989;6730- 36
Riedel  KGGabel  VPNeubauer  LKampik  ALund  OE Intravitreal silicone oil injection: complications and treatment of 415 consecutive patients. Graefes Arch Clin Exp Ophthalmol. 1990;22819- 23
Barr  CCLai  MYLean  JS  et al.  Postoperative intraocular pressure abnormalities in the Silicone Study: Silicone Study Report 4. Ophthalmology. 1993;1001629- 1635
Nguyen  QHLloyd  MAHeuer  DK  et al.  Incidence and management of glaucoma after intravitreal silicone oil injection for complicated retinal detachments. Ophthalmology. 1992;991520- 1526
Burk  LLShields  MBProia  ADMcCuen  BW  II Intraocular pressure following intravitreal silicone oil injection. Ophthalmic Surg. 1988;19565- 569
de Corral  LRCohen  SBPeyman  GA Effect of intravitreal silicone oil on intraocular pressure. Ophthalmic Surg. 1987;18446- 449
Ehud  AVarda  CJoseph  MGiora  T Management of complicated retinal detachment by vitrectomy and silicone oil injection. Metab Pediatr Syst Ophthalmol. 1988;1163- 66
Leaver  PK Complications of intraocular silicone oil. Ryan  SJGlaser  BMedsRetina. Vol 32nd ed. St Louis, Mo Mosby Year Book Inc1994;2165- 2179
Roussat  BRuellan  YM Treatment of retinal detachment by vitrectomy and injection of silicone oil: long-term results and complications in 105 cases [in French]. J Fr Ophtalmol. 1984;711- 18
Nowack  CLucke  KLaqua  H Removal of silicone oil in treatment of so-called emulsification glaucoma [in German]. Ophthalmologe. 1992;89462- 464
Leaver  PKGrey  RHGarner  A Silicone oil injection in the treatment of massive preretinal retraction, II: late complications in 93 eyes. Br J Ophthalmol. 1979;63361- 367
Leaver  PKGrey  RHGarner  A Complications following silicone-oil injection. Mod Probl Ophthalmol. 1979;20290- 294
Ando  F Intraocular hypertension resulting from pupillary block by silicone oil. Am J Ophthalmol. 1985;9987- 88
Zborowski-Gutman  LTreister  GNaveh  NChen  VBlumenthal  M Acute glaucoma following vitrectomy and silicone oil injection. Br J Ophthalmol. 1987;71903- 906
Haut  JUllern  MChermet  MVan Effenterre  G Complications of intraocular injections of silicone combined with vitrectomy. Ophthalmologica. 1980;18029- 35
Chan  COkun  E The question of ocular tolerance to intravitreal liquid silicone. Ophthalmology. 1986;93651- 660
Bartov  EHuna  RAshkenazi  I  et al.  Identification, prevention, and treatment of silicone oil pupillary block after an inferior iridectomy. Am J Ophthalmol. 1991;111501- 504
Laganowski  HCLeaver  PK Silicone oil in the aphakic eye: the influence of a six o'clock peripheral iridectomy. Eye. 1989;3338- 348
Elliott  AJBacon  ASScott  JD The superior peripheral iridectomy: prevention of pupil block due to silicone oil. Eye. 1990;4 ((pt 1)) 226- 229
Moisseiev  JBarak  AManaim  TTreister  G Removal of silicone oil in the management of glaucoma in eyes with emulsified silicone. Retina. 1993;13290- 295
Han  DPLewis  HLambrou  FH  JrMieler  WFHartz  A Mechanisms of intraocular pressure elevation after pars plana vitrectomy. Ophthalmology. 1989;961357- 1362
Weinberg  RSPeyman  GAHuamonte  FU Elevation of intraocular pressure after pars plana vitrectomy. Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1976;200157- 161
Lucke  KStrobel  BFoerster  MLaqua  H Secondary glaucoma after silicone oil surgery [in German]. Klin Monatsbl Augenheilkd. 1990;196205- 209
Petersen  JRitzau-Tondrow  U Chronic glaucoma following silicone oil implantation: a comparison of two oils of differing viscosity. Fortschr Ophthalmol. 1988;85632- 634
Arevalo  JFMunguia  DFaber  D  et al.  Correlation between intraocular pressure and CD4+ T-lymphocyte counts in patients with human immunodeficiency virus with and without cytomegalovirus retinitis. Am J Ophthalmol. 1996;12291- 96
Madreperla  SAMcCuen  BW  II Inferior peripheral iridectomy in patients receiving silicone oil: rates of postoperative closure and effect on oil position. Retina. 1995;1587- 90
Lewis  HAaberg  T Anterior proliferative vitreoretinopathy. Am J Ophthalmol. 1988;105277- 284
Lewis  HAaberg  TAbrams  G Causes of failure after initial vitreoretinal surgery for severe proliferative vitreoretinopathy. Am J Ophthalmol. 1991;1118- 14
Lewis  HAaberg  T Causes of failure after repeat vitreoretinal surgery for recurrent proliferative vitreoretinopathy. Am J Ophthalmol. 1991;11115- 19
Lewis  HVerdaguer  J Surgical treatment for chronic hypotony and anterior proliferative vitreoretinopathy. Am J Ophthalmol. 1996;122228- 235
Diddie  KRAzen  SPFreeman  HM  et al.  Anterior proliferative vitreoretinopathy in the silicone study: Silicone Study Report Number 10. Ophthalmology. 1996;1031092- 1099

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