Sudden Visual Loss After Removal of Silicone Oil

In Brief Purpose: Removal of silicone oil after vitreoretinal surgery reduces potential complications of glaucoma and cataract and improves visual function in 30% of patients. We report the clinical findings of a series of patients who experienced unexpected and permanent visual loss after removal of silicone oil. Methods: Seven patients with visual loss after removal of silicon oil were investigated with best-corrected Snellen visual acuity (BCVA) assessment, fundus biomicroscopy, fluorescein angiography, optical coherence tomography, and electrophysiologic examination. Results: Six men and one woman (average age, 42.8 years.) presented with profound BCVA loss, averaging 4.7 Snellen lines (SD 1.4), after silicon oil removal. No other complications associated with oil removal were noted. The retina remained attached in all cases, no patient developed cystoid macular edema or epiretinal membrane, and optical coherence tomographic and fluorescein angiographic findings remained normal. Electrodiagnostic testing showed a range of abnormalities, with the majority of patients showing severe macular dysfunction Conclusions: We describe a new phenomenon of unexpected visual loss after oil removal in patients with good visual potential. The pathogenesis remains obscure. The authors report seven patients who experienced visual loss following removal of silicone oil. Loss of best corrected vision averaged 4.5 lines. Fundus biomicroscopy, OCT and fluorescein angiograms were normal, however severe pattern electroretinogram abnormalities indicated macular dysfunction in six patients with some having more generalized retinal involvement. The possible pathogenesis is discussed.