Use of silicone oil in the repair of giant retinal tears in the pediatric patient

PURPOSE: To evaluate the effectiveness of silicone oil as a long term internal tamponade in the repair of rhegmatogenous retinal detachments due to giant retinal tears in the pediatric patient. METHODS: Seven eyes of six pediatric aged patients who developed a rhegmatogenous retinal detachment due to giant retinal tears were retrospectively reviewed. Each patient underwent a pars plana vitrectomy, perfluorocarbon fluid injection, endolaser photocoagulation and long term internal tamponade with 1000 centistokes silicone oil. Patients ranged in age from 7 to 17 years, preoperative vision ranged from 20/200 to light perception and minimum follow-up was 6 months following repair. RESULTS: 100% of the patients had complete anatomical reattachment. Five of seven eyes attained 20/60 or better visual acuity postoperatively with the remaining eyes attaining counts fingers and light perception vision. Poor vision patients resulted from proliferative vitreoretinopathy (PVR) and submacular retinal pigment epithelial (RPE) changes. Two patients required one additional surgery (other than silicone oil removal) due to macular pucker. There were no silicone oil complications. CONCLUSION: The use of silicone oil as the postoperative tamponade in the repair of rhegmatogenous retinal detachments secondary to giant retinal tears in the pediatric patient provides an excellent alternative to gas tamponade and obviates the difficulties of head positioning in this age group.