Gas tamponade linked to better vision outcomes than silicone oil

The authors investigated the effect of 2 tamponading agents on retinal thickness in eyes that underwent surgery for macula-on retinal detachment (RD).

Study design

The retrospective analysis included 33 eyes that received silicone oil tamponade and 31 eyes that received gas tamponade for the treatment of rhegmatogenous RD. The primary outcome measure was the change in thickness of each retinal layer in the central 1 mm zone, as determined by spectral domain OCT.

Outcomes

At 6 months postop, eyes in the silicone oil group had a statistically significant decrease in total retinal thickness. All retinal layers, with the exception of the photoreceptor layer, were significantly thinner (P<0.001). In contrast, eyes in the gas group did not experience any significant changes in total retinal thickness or in the measurements of any individual retinal layer.

Postoperative BCVA in the silicone oil group was significantly worse than the gas group at 6 and 9 months (P=0.003 and P=0.004, respectively).

Postoperative decreases in the ganglion cell layer, outer plexiform layer and outer nuclear layer thicknesses significantly correlated with worse BCVA in the silicone oil group (all P<0.05).

Limitations

The study is retrospective and patients were not randomized. The choice of agent was based on surgeon preference.

Clinical significance

Although the pathogenic mechanism of silicone oil toxicity remains unclear, the findings here suggest that silicone oil tamponade leads to poorer vision outcome than gas agents. OCT segmentation analysis could prove useful for detecting early retinal thinning in patients treated with silicone oil tamponade.