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The following is a summary of “Effect of silicone oil versus gas tamponade on macular layer microstructure after pars plana vitrectomy for macula on rhegmatogenous retinal detachment,” published in the March 2024 issue of Ophthalmology by Al-Shehri et al.

Researchers conducted a retrospective study to assess alterations in macular retinal layers and sub-foveal choroidal thickness (SFCT) post-repair of macula-on rhegmatogenous retinal detachment (RRD) via pars plana vitrectomy, comparing outcomes between silicone oil (SO) and gas tamponade, and evaluating their impact on visual acuity.

They conducted a study involving 26 eyes in the SO Group and 32 eyes in the Gas Group. optical coherence tomography (OCT) scans were acquired before surgery and 3 months after pars plana vitrectomy (PPV) in the Gas Group, while in the SO Group, scans were obtained during SO in situ and 3 months after SO removal. A qualitative assessment of the photoreceptor layer and foveal contour, along with a quantitative evaluation of macular retinal thickness and SFCT, was conducted. Postoperative OCT analysis of macular microstructural changes was conducted and correlated with corrected distance visual acuity (CDVA). Intraocular pressure (IOP) was measured preoperatively and at 3 months postoperatively.

The results showed that there was a 2-line loss (from 20/28 preoperatively to 20/40 at final follow-up) of CDVA in the SO Group (P=0.051), while CDVA in the Gas Group remained unchanged (P=0.786). No significant correlation between CDVA loss and duration of silicone tamponade (r=-0.031, P=0.893). IOP increased by 0.7 mmHg in the SO Group (P=0.023), with no significant change in the Gas Group. During SO tamponade, 11% and 5% of retinal and SFCT occurred, partially resolved after SO removal. Qualitative flattening of foveal contour was observed in 20% (5/24) of eyes in the SO Group during SO tamponade, resolving after SO removal.

Investigators concluded that Macula-on RRD repair with SO tamponade may cause persistent macula thinning despite SO removal.

Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03377-x