Abstract
Purpose
Silicone oil (SO) tamponade and the removal of silicone oil (ROSO) in the management of complex retinal detachments carry well-defined postoperative complications. Our objective was to classify and grade complications following ROSO using the Complications of Retinal Detachment Surgery (CORDS) Severity Classification and to propose a unifying proof-of-concept complication score.Methods
A single-centre retrospective case series of eyes undergoing ROSO was performed between 2018 and 2022. All patient data were collected with 12-month follow-up. Best recorded visual acuity (BRVA, LogMAR), intraocular pressure (IOP, mmHg) and complications were recorded from electronic patient records (EPR). Complications were scored using the CORDS Severity Classification. A Modified Global Complication Score (MGCS) was calculated for our study cohort.Results
SO was removed from 46 eyes with a mean (SD) tamponade duration of 8.2 (6.61) months. A total of 88 de-duplicated CORDS items were recorded over the 12-month follow-up. Serious complications included anterior displacement of SO (12.5%), retinal re-detachment (5.68%), raised IOP requiring treatment (14.8%), severe loss of vision (18.9%), corneal decompensation (5.68%) and phthisis (2.27%). There was a statistically significant effect of timepoint on mean complication scores (χ² [3] = 11.22, P = 0.011); the effect greatest between the 3-month and 6-month timepoints (P = 0.002). The MGCS was 9.66% for our cohort.Conclusion
Postoperative complications following ROSO are common with high severity complications, such as secondary glaucoma, corneal decompensation and phthisis, emerging at 3-6 months. Our study proposes the MGCS as an exploratory comparison measure between future studies, but requires further validation in larger prospective cohorts that apply the CORDS Severity Classification.