Silicone oil tamponade in retinal detachment associated with retinal necrosis syndrome

Background: Because retinal necrosis syndrome seldom occurs, we present our results of silicone oil tamponade for associated retinal detachment. Patients and methods: Thirteen eyes from 13 patients undergoing retinal reattachment surgery for retinal detachment associated with acute retinal necrosis in a consecutive series between January 1988 and June 1995 were followed up. Patients were 25 to 56 years of age. Four patients had acquired immune deficiency syndrome (AIDS). Five eyes that were operated on with cryopexy and scleral buckling received vitrectomy, membrane peeling, silicone oil tamponade and endolaser treatment in a second operation. Eight eyes were primarily operated on with cryopexy, encircling buckle, vitrectomy with membrane peeling, silicone oil tamponade and endolaser treatment. All patients were treated with acyclovir. Results: Postoperative complete reattachment was observed in 12 eyes and persistence of a peripheral detachment in one eye. Vision improved in eight eyes, but only five eyes achieved 20/200 or better vision. Limited functional results in our series were caused by retinal ischemia, optic atrophy and macula scars. After a median of 9.3 months silicone oil was removed in nine eyes. No retinal redetachment or recurrent retinitis was observed during a follow-up time of at least 6 months. Conclusions: Vitrectomy and silicone oil tamponade allowed all cases of retinal detachment associated with acute retinal necrosis to be successfully repaired. Further studies must be conducted to find out how we can improve the visual outcome perhaps by earlier therapy with acyclovir or earlier vitrectomy.