Residual Silicone Oil After Retinal Detachment Surgery

Retinal detachment surgery with incomplete removal of silicone oil?

Hello Doctor, I had a retinal detachment injury affecting the macula in July last year, and I underwent surgery where silicone oil was injected.
The silicone oil was removed on December 12th of last month.
The day after the surgery, during my follow-up visit, I noticed small black dots and oil-like substances moving around in my vision.
The doctor mentioned that he did his best to remove the silicone oil, but some remnants remain in my eye, which is causing the black oil-like spots to float around.
Is it possible for silicone oil to be completely removed? Is this considered abnormal? My vision was normal at 1.0 before the detachment, but now, after the silicone oil removal, there are still some remnants left in my eye.
Currently, my vision is 0.1, and everything appears blurry, making it difficult to see clearly at any distance.
Will my vision improve?

Zhihong, 40~49 year old female. Ask Date: 2019/01/03

Dr. He Jianxian reply Ophthalmology

Silicone oil may occasionally encounter incomplete removal, but most of the time it does not cause issues.
Your retina may have sustained damage during the detachment, particularly in the macula, so restoring your original vision may be somewhat challenging.

Reply Date: 2019/01/03

More Info

After undergoing retinal detachment surgery with silicone oil injection, it is not uncommon for patients to experience residual silicone oil in the eye. This situation can lead to various visual disturbances, including the perception of "floaters" or dark spots, which you described as "black ink floating around." This phenomenon is often due to the presence of silicone oil that remains in the eye after the surgical procedure.

1. Residual Silicone Oil: It is indeed possible for silicone oil to remain in the eye after an attempt to remove it. The reasons for this can vary; sometimes, the oil can adhere to the retinal surface or other intraocular structures, making complete removal challenging. In some cases, the oil may be trapped in areas that are difficult to access surgically. While it is not ideal for patients to have residual silicone oil, it is not uncommon, and many patients experience some degree of this after surgery.

2. Visual Disturbances: The presence of residual silicone oil can lead to visual disturbances, such as blurred vision or the perception of floaters. These symptoms can be particularly pronounced if the oil is located near the visual axis. The fact that you are experiencing a significant decrease in visual clarity, with your vision described as "foggy," could be attributed to the residual silicone oil, as well as potential changes in the retina or other structures following the surgery.

3. Recovery of Vision: Regarding the recovery of your vision, it is essential to understand that the healing process after retinal surgery can take time. The retina may need several months to stabilize and recover its function. If the silicone oil is causing significant visual disturbances, your ophthalmologist may discuss options for further intervention, including the possibility of additional surgery to remove the remaining oil, if deemed necessary.

4. Normalcy of the Situation: While having residual silicone oil is not the most desirable outcome, it is not considered abnormal in the context of complex retinal surgeries. Many patients experience similar situations, and the management of residual silicone oil is a common topic of discussion in follow-up appointments. It is crucial to maintain open communication with your ophthalmologist about your symptoms and any concerns you may have.

5. Future Considerations: If your vision does not improve or if you continue to experience significant visual disturbances, further evaluation may be warranted. Your doctor may consider additional imaging studies or a thorough examination to assess the condition of your retina and the status of the residual silicone oil. Depending on the findings, they may recommend further treatment options.

In conclusion, while the presence of residual silicone oil can lead to visual disturbances and may affect your overall vision, it is a recognized complication of retinal detachment surgery. Continuous follow-up with your ophthalmologist is essential to monitor your condition and address any concerns you may have. They can provide tailored advice based on your specific situation and help you navigate the recovery process effectively.

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