Ursachen und Risikofaktoren für erneute Netzhautablösungen nach Silikonölentfernung bei verschiedenen vitreoretinalen Grunderkrankungen

Reasons and risk factors for recurrent retinal detachments after removal of silicone oil in different vitreoretinal diseases Pars plana vitrectomy combined with silicone oil tamponade is a standard in the treatment of retinal detachments, even in complicated cases success rates of 85% to 90% are possible. (Feltgen und Walter 2014) Despite the well developed operational technique there are still recurrent cases of retinal detachment (reablatio retinae) after silicone oil removal, redetachment with in situ oil tamponade is possible, too. This serious complication may lead to worse functional outcomes for the patients and has to be avoided at all costs. There are only few studies, which describe possible risk factors in detail; therefore, the aim of this retrospective study is to find possible reasons for retinal redetachment to be able to use the knowledge for optimizing the treatment. In this retrospective study 43 eyes of patients were analysed, who were treated with PpV and silicone oil tamponade in the ophthalmic clinic in Marburg in the years 2010 to 2015 and who had a retinal redetachment during that time. To evaluate the results, the patients were divides in groups with redetachment with oil in situ (21 eyes) and redetachment after oil removal (22 eyes). For the analysis and comparison patient data, intraoperative findings at primary detachment and redetachment and functional outcomes were used. Several possible risk factors could be determined from this data: PVR was involved in the redetachment in most of the eyes and can be seen as a main risk factor for redetachment with oil in situ and after oil removal. Preceding operations, for example unsuccessful PpV with gas tamponade or cataract operations, were present in almost all the eyes and may be considered as a reason for the redetachment. Retinal tears, especially macular holes, have a tendency reopen and therefore count as a risk factor. A retinal redetachment with oil in situ also increases the possibility of redetachment after silicone oil removal. All of these risk factors confirm those observed in literature and should be considered in the planning of an optimal therapy.