Unexplained vision loss with intra‐ocular silicone oil tamponade in situ: a case series

PurposeSilicone oil provides a long‐lasting retinal tamponade which is of particular benefit when attempting to repair complex retinal detachments associated with proliferative retinopathy and giant retinal tears. There have been reports of sudden unexplained visual loss secondary to the use of silicone oil tamponade, often after removal of silicone oil, which is typically severe and permanent. We report a case series of patients who lost vision with silicone oil tamponade in situ.MethodsObservational report and analysis of three cases of unexplained vision loss with silicone oil tamponade in situ for retinal detachment surgery.ResultsThree cases of unexplained vision loss with silicon oil tamponade were analysed. Two were male and the average age was 55 (51–62 years). 2 cases were macular on retinal detachments. 3 months post operatively, visual acuity was 6/9 in two cases and 6/12 in the third case with silicone oil in situ. Silicone oil 2000cs was used in all cases and the primary success rate was 100%. All had normal intra ocular pressure, fundal examination and optical coherence tomography at 3 months. Loss of vision occurred at 5 months post‐surgery with silicone oil in situ in all three cases. Visual acuities dropped to 6/60, 6/36 and 6/36 respectively. Silicone oil was removed in all cases and visual acuities were 6/36, 6/60 and 2/60 at 1 year following silicon oil removal. Electro‐diagnostic tests confirmed reduced macular function in the affected eyes.ConclusionsUnexplained vision loss secondary to silicone oil tamponade is severe and permanent. The etiology is still unknown and further work is required to identify the incidence and potential risk factors for this devastating phenomena. A better understanding of this condition would enable us to manage these cases more appropriately and reduce the likelihood of it occurring.