Erakgun Tansu1, Nalcaci Serhad. 1. Department of Ophthalmology, Ege University Hospital, Izmir, Turkey. ethem.tansu.erakgun@ege.edu.tr
Abstract
PURPOSE: The purpose was to study the anatomical outcome of choroidal coloboma with retinal detachment managed by pars plana vitrectomy with silicone oil tamponade using optical coherence tomography. METHODS: Six eyes of six patients with retinal detachment related to choroidal coloboma underwent pars plana vitrectomy with internal tamponade using silicone oil. Pre- and postoperative best-corrected visual acuities, intraocular pressure measurements, and intra- and postoperative complications were obtained. Color fundus photographs and optical coherence tomography images were taken at each follow-up. RESULTS: Patients were observed up to a mean of 14 months (range, 8-18 months). Silicone oil was removed in all eyes. In all patients who had undergone vitrectomy, the retina was completely reattached before and after silicone oil extraction. Postoperatively, best-corrected visual acuities improved in 5 patients and remained unchanged in 1 patient ranging from 20/200 to 20/40 at the last follow-up. Although the retina was reattached in all patients, the optical coherence tomography showed a persistent intercalary membrane detachment in 4 patients (67%). In 1 patient (16%), subclinical retinal detachment that did not increase during the follow-up after silicone oil removal was detected just beyond the margin of the coloboma. CONCLUSION: After vitrectomy and silicone oil removal, optical coherence tomography showed persistent detachment of the intercalary membrane in most patients. These findings emphasize the importance of sealing the junction between the intercalary membrane and extracolobomatous retina with a laser barrier.
PURPOSE: The purpose was to study the anatomical outcome of choroidal coloboma with retinal detachment managed by pars plana vitrectomy with silicone oil tamponade using optical coherence tomography. METHODS: Six eyes of six patients with retinal detachment related to choroidal coloboma underwent pars plana vitrectomy with internal tamponade using silicone oil. Pre- and postoperative best-corrected visual acuities, intraocular pressure measurements, and intra- and postoperative complications were obtained. Color fundus photographs and optical coherence tomography images were taken at each follow-up. RESULTS:Patients were observed up to a mean of 14 months (range, 8-18 months). Silicone oil was removed in all eyes. In all patients who had undergone vitrectomy, the retina was completely reattached before and after silicone oil extraction. Postoperatively, best-corrected visual acuities improved in 5 patients and remained unchanged in 1 patient ranging from 20/200 to 20/40 at the last follow-up. Although the retina was reattached in all patients, the optical coherence tomography showed a persistent intercalary membrane detachment in 4 patients (67%). In 1 patient (16%), subclinical retinal detachment that did not increase during the follow-up after silicone oil removal was detected just beyond the margin of the coloboma. CONCLUSION: After vitrectomy and silicone oil removal, optical coherence tomography showed persistent detachment of the intercalary membrane in most patients. These findings emphasize the importance of sealing the junction between the intercalary membrane and extracolobomatous retina with a laser barrier.