Interesting Cases

Timely Removal Of Silicon Oil

I would like to stress the timely removal of silicon oil in patients who have undergone successful vitreo retinal surgeries. Sometimes primary retinal surgeons not remove the oil in time & patient becomes blind because of Glaucoma. the following two cases illustrate the point.

Patient 1: 13-00221

·         This 31 yr old male patient presented to me on 4-2-13, with complains of blurred vision in right eye. He had been operated vitrectomy with oil for retinal detachment on 13-12-2010 elsewhere.  He had previously undergone LASIK and multifocal IOL implants in both eyes elsewhere.

·         The BCVA in RE was CF 3 mts and slit lamp showed multifocal implants. Fundus showed glaucomatous disc in right eye and myopic disc in left eye, with myopic macula in both eyes. He was on treatment with Combigan, Misopt and ganfort eye drops, and IOP was 13 mm Hg in RE.

·         He underwent oil removal on 12-2-13.

·         on  12-03-2013 vision is 6/60 N36, retina attached & patient is on Timolet eye drop 2 times a day with IOP of 20mm of hg in right eye

Patient 2:- 10-02227

·         This 61 yrs old one eyed male presented to me on 20-11-2010 with past history of vitrectomy with silicon oil in 2008 for retinal detachment

·         His BCVA in left eye was 6/60 N36, fundus showed myopic & glaucomatus disc & macula, retina attached, IOP 19mm of hg with Travatan eye drop once a day, Iotim eye drop 2 times a day & Dorzox eye drop 3 times  a day

·         He was advised silicon oil removal.

·         He came again on 03-08-2012. His visual acuity dropped to counting finger @ 2mt. Funuds showed retina attached, IOP 20mm of hg with Travacom eye drop once a day, Alfagan Z  eye drop 2 times a day, Dorzox eye drop  times a day

·         He was advised silicon oil removal.

·         He came on 21-03-2013 with Hand movement vision & IOP of 34mm of hg.

·         Patient had stopped  all glaucoma treatment as he was loosing vision.

In above 2 patients timely silicon oil removal could have controlled glaucoma better & saved usedfull vision. In my opinion quiet  a few retinal surgeons are scared to remove silicon oil with fear of retinal redetachment. However with good previous retinal surgeries & case selections this can be minimized to a great extent by timely removal of silicon oil  & we would be able to save the eye from potencially blinding glaucoma.