Large Retinectomies for Retinal Detachment Complicated by Proliferative Vitreoretinopathy: Anatomical and Functional Outcome of Silicone Oil versus Perfluoropropane Gas

Figures & data

Table 1 Baseline Characteristics of the Patients

Preoperative Parameters	Overall (n=66)	Gas (n=20)	Silicone Oil (n=46)	P value
Age (years)
Mean	65.3	67.55±15.69	64.32±12.9	0.38^
Range	28–92	44–92	28–88
Gender (%)
Male	41 (62.12%)	12 (60%)	29 (63.04%)	1.00
Female	25 (37.88%)	8 (40%)	17 (36.96%)
Lens status (%)
Pseudophakic	53 (80.30%)	17 (85%)	36 (78.26%)	0.73
Phakic	13 (19.70%)	3 (15%)	10 (21.74%)
3Reason for retinectomy (%)
Recurrent RD	54 (81.81%)	16 (80%)	38 (82.60%)	1.00
Primary RD	12 (18.19%)	4 (20%)	8 (17.40%)
Visual acuity (logMAR) mean	1.679	1.505	1.72	0.3852^$
Visual acuity (Snellen), n (%)
Light perception	8 (12.12%)	2 (10%)	6 (13.04%)	1.00*
Hand motion	29 (43.93%)	9 (45%)	20 (43.48%)	1.00
Count fingers	21 (31.81%)	6 (30%)	15 (32.60%)	1.00*
≥20/400	8 (12.12%)	3 (15%)	5 (10.87%)	0.69*
Macula status (%)
Detached	62 (93.93%)	19 (95%)	43 (93.47%)	1.00*
Attached	4 (6.06%)	1 (5%)	3 (6.52%)
Prior operations (%)
Scleral buckle	7 (12.96%)	2 (12.5%)	5 (13.15%)	1.00*
Vitrectomy	41 (75.93%)	11 (68.75%)	30 (78.95%)	0.58
Combined	6 (11.11%)	3 (18.75%)	3 (7.9%)	0.36
Number of previous vitreoretinal operations (%)
Mean	1.04	1	1.06
0	10 (15.15%)	4 (20%)	6 (13.04%)	0.48
1	44 (66.66%)	13 (65%)	31 (67.39%)	1.00
2	11 (16.66%)	2 (10%)	9 (19.56%)	0.48
3	1 (1.51%)	1 (5%)	0	0.30

Notes: ^ttest, *Fisher’s exact test, ^$Mann–Whitney U-test.

Table 2 Intraoperative Parameters

Intraoperative Parameters	Overall (n=66)	Gas (n=20)	Silicone Oil (n=46)	P value*
Retinotomy size (%)
180°	27 (40.90%)	11 (55%)	16 (34.78%)	0.17
>180° and <360°	12 (18.18%)	4 (20%)	8 (17.39%)	0.74
360°	27 (40.90%)	5 (25%)	22 (47.82%)	0.11
PVR classification (%)
Posterior (C1 or C2)	29 (43.93%)	10 (50%)	19 (41.30%)	0.59
Subretinal (C3)	15 (22.72%)	3 (15%)	12 (26.08%)	0.52
Anterior (C4 or C5)	22 (33.33%)	7 (35%)	15 (32.60%)	1.00

Note: *Fisher’s exact test.

Abbreviation: PVR, proliferative vitreoretinopathy.

Table 3 Postoperative Findings

Postoperative Parameters	Overall (n=66)	Gas (n= 20)	Silicone Oil (n= 46)	P value
Anatomic success after initial retinotomy (%)	53 (80.30%)	14 (70%)	39 (84.78%)	0.19
Initial anatomic success based on baseline PVR (%)
Posterior	27/20 (74.07%)	8/5 (62.5%)	19/15 (78.94%)	1.00
Subretinal	18/15 (83.33%)	6/3 (50%)	12/12 (100%)	0.024 $
Anterior	21/18 (85.71%)	6/6 (100%)	15/12 (80%)	0.53
Visual acuity (logMAR) mean	1,424	1,145	1.546	0.027 $
Visual acuity (Snellen), n (%)
Light perception	2 (3.03%)	0 (0%)	2 (5.00%)	1.00
Hand motion	15 (22.72%)	2 (10%)	13 (28.26%)	0.12
Count fingers	22 (33.33%)	6 (30%)	16 (34.78%)	0.78
20/400	7 (10.60%)	3(15%)	4 (8.69%)	0.42
≥20/200	15 (22.72%)	7 (35%)	8 (17.39%)	0.20
Intraocular pressure (%)
Normal (6–21mmHg)	55 (83.33%)	17 (85%)	38 (82.60%)	1.00*
Low (≤5 mmHg)	9 (13.63%)	3 (15%)	6 (13.04%)	1.00
High (22–30 mmHg)	2 (3.03%)	0	2 (4.38%)	1.00
Complications (%)
Recurrent PVR	18 (27.27%)	3 (15%)	15 (32.60%)	0.23
ERM	10 (15.15%)	4 (20.00%)	6 (13.04%)	0.48
Silicone oil in anterior chamber	7 (10.60%)	–	7 (15.21%)	–
Band keratopathy	2 (3.03%)	–	2 (4.34%)	–
Phthisis bulbi	1 (1.51%)	0	1 (2.17%)	1.00*
Recurrent retinal detachment	13 (19.69%)	6 (30%)	7 (15.21%)	0.19

Notes: *Fisher’s exact test. ^$ Mann–Whitney U-test.

Abbreviations: PVR, proliferative vitreoretinopathy; ERM, epiretinal membrane.

Figure 1 Overall logMar preoperative vs final VA.

Figure 2 Snellen visual acuity preop/postop in silicone oil, gas filled, and in all cases.

Table 4 Parameters That May Influence Final Visual Acuity

Parameters	Median Snellen VA	Mean logMAR VA	P value *
Age
<60 years (n=19)	CF	1.2473	0.104
≥60 years (n=47)	CF	1.4957
Posterior PVR
Present (n=27)	CF	1.36	0.43
Not present (n=39)	CF	1.47
Subretinal PVR
Present (n=15)	CF	1.61	0.15
Not present (n=51)	CF	1.37
Anterior PVR
Present (n=24)	CF	1.38	0.66
Not present (n=42)	CF	1.45
Intraocular tamponade
Gas (n=20)	CF	1.67	0.85
Silicone oil (n=46)	CF	1.75
Anatomical outcome
Attached retina (n=59)	CF	1.38	0.043
Detached retina (n=7)	HM	1.82
Preoperative VA
≤CF (n=55)	HM > CF	1.78 >/1.61	0.0017
>CF (n=11)	1/10 > 2/10	1.018 > 0.49	0.0033
Primary operation
Yes (n=10)	HM > HM	1.8 > 1.7	0.55
No (n=56)	HM > CF	1.63 > 1.38	>0.001
Preoperative macula status
Attached (n=6)	2/10 > 5/10	0.78 > 0.42	0.15
Detached (n=60)	HM > CF	1.74 > 1.53	0.0001

Note: * Mann–Whitney U-Test.

Abbreviations: PVR, proliferative vitreoretinopathy; VA, visual acuity; CF, count fingers; HM, hand motions.