Refractive status and visual acuity changes after oil removal in eyes following phacovitrectomy, intraocular lens implantation, and silicone oil tamponade

Objective: To examine the refractive changes in pseudophakic eyes with silicone oil tamponade (SOT) and removal. Design: Retrospective review. Participants: Twenty-six consecutive eyes (23 patients) that had undergone phacovitrectomy, posterior chamber intraocular lens (IOL) implantation, and SOT by a single surgeon. Methods: Phacoemulsification and biconvex-type foldable acrylic IOLs were implanted. A standard 3-port pars plana vitrectomy was performed using a 20-gauge vitrectomy system. Following fluid air exchange, 1300 centistokes silicone oil (SO) was injected. Manifest refractions with SOT and after SO removal were performed using best-spectacle correction based on retinoscopy results at least 1 month after each surgery. Results: A mean spherical equivalent of 3.85 (SD 1.63) diopters (D) and logMAR best-corrected visual acuity (BCVA) of 0.77 (SD 0.50) were observed with SOT. After SO removal, a myopic shift of -4.51 (SD 1.79) D was observed, resulting in -0.66 (SD 1.40) D, which concurred with the preoperative target of -0.47 (SD 0.50) D (p = 0.465, paired t test) and logMAR BCVA of 0.65 (SD 0.52) (p = 0.131, paired t test). Multivariate linear regression analysis demonstrated that the axial length and refractive index of the IOL were significant factors in determining refraction in oil-filled pseudophakia (p = 0.000). Conclusions: Phacovitrectomy, IOL implantation, and SOT resulted in a tolerable range of hyperopia and visual acuity comparable to that after SO removal.