Introduction: To compare the emulsification rates, intraocular pressure (IOP) changes, and retinal hyper-reflective foci (HRF) between low-viscosity (1000 cS) and high-viscosity (5000 cS) silicone oil (SO) used as tamponade agents following 25-gauge pars plana vitrectomy (PPV) in cases of naïve macula-off rhegmatogenous retinal detachment (RRD) using an artificial-intelligence (AI)–based quantification approach. Methods: Retrospective study conducted in eyes treated with PPV and SO tamponade. Clinical parameters assessed included best-corrected visual acuity (BCVA), intraocular pressure (IOP), presence of emulsification in the irido-corneal angle, in anterior or posterior chambers and structural retinal biomarkers such as intraretinal fluid (IRF), subretinal fluid (SRF) and hyperreflective foci (HRF) detected and quantified through an AI-based analysis of spectral-domain OCT images. Results: Twenty-five eyes were enrolled (12 with 1000 cS SO and 13 with 5000 cS SO endotamponades). No statistically significant differences were found in BCVA or anatomical outcomes between the two groups. However, SO emulsification occurred more often in the 1000 cS group (66%) compared to the 5000 cS group (7%) (p = 0.0036). Elevated IOP was more frequent in the 1000 cS group (8 vs. 4 cases; p = 0.03), and HRF count was significantly higher in eyes with 1000 cS oil (p = 0.04). Conclusions: High-viscosity SO demonstrated a lower emulsification rate and reduced inflammatory response compared to low-viscosity SO, with no compromise in visual outcomes. AI-assisted OCT analysis enabled an accurate, automated detection of HRF, supporting its utility in monitoring SO-related complications.
Mariotti et al. (Thu,) studied this question.