Visusverlust nach Silikonölchirurgie

Zusammenfassung

In der Therapie komplizierter Netzhautablösungen kommt dem Silikonöl als intraokularer Tamponade eine wichtige Funktion zu. Es ist durch seine Langzeitwirkung in der Lage, die Wiederanlagerate der Retina nach deren Ablösung zu erhöhen und damit die Visusprognose zu verbessern. Abweichend von diesen Erwartungen werden in den letzten Jahren Fälle von Visusminderungen nach Silikonölchirurgie beobachtet, die irreversibel verlaufen und deren Genese unklar bleibt. Diese Arbeit bezweckt, einen Überblick über die Erkenntnisse, die bisher zu diesem Phänomen existieren, zu geben. Die Hinweise auf solche unglücklichen Verläufe mehren sich derart, dass die Retinologische Gesellschaft mit der Unterstützung des Retinanet (http://retina-net.uni-koeln.de) eine laufende Datensammlung realisiert hat in Zusammenarbeit mit der Augenklinik der Uniklinik Köln. Klinische Daten zu Patienten sollen gesammelt werden, um die Verläufe besser charakterisieren zu können und mögliche Ursachen zu finden. Behandelnde Augenärzte können Fälle unklarer Visusminderungen nach Silikonölchirurgie anonym melden. Eine Kontaktaufnahme hierfür ist über das Zentrum für Klinische Studien der Uniklinik Köln oder über die E-Mail-Adresse [e-mail] möglich.

Abstract

Silicone oil is an intraocular tamponade that is essential for the treatment of complicated retinal detachment. As a long-term tamponade, it improves retinal reattachment and visual outcome. Unexpectedly, surgery with silicone oil tamponade may result in irreversible visual loss of unknown origin. In this report, we provide a general overview of unexplained visual loss after surgery with silicone oil. The frequency of such reports has increased continuously in recent years. The German Retina Society – supported by Retinanet (http://retina-net.uni-koeln.de) – has initiated data collection to gather information about such cases, in cooperation with Cologne University Eye Hospital. Ophthalmologists can provide data about cases of unexplained visual loss anonymously via the “Cologne Clinical Trials Centre” or via [e-mail].

Schlüsselwörter

Vitrektomie - Retina - Silikonöl - Visus - Netzhautchirurgie

Key words

vitrectomy - retina - silicone oil - visual acuity - retinal surgery

• Literatur

• 1 Abrams GW, Azen SP, McCuen BW. et al. Vitrectomy with silicone oil or long-acting gas in eyes with severe proliferative vitreoretinopathy: results of additional and long-term follow-up. Silicone Study report 11. Arch Ophthalmol 1997; 115: 335-344
• 2 [Anonymous] Vitrectomy with silicone oil or sulfur hexafluoride gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial. Silicone Study Report 1. Arch Ophthalmol 1992; 110: 770-779
• 3 Newsom RS, Johnston R, Sullivan P. et al. Visual loss following silicone oil removal. Br J Ophthalmol 2005; 89: 1668
• 4 Herbert EN, Habib M, Steel D. et al. Central scotoma associated with intraocular silicone oil tamponade develops before oil removal. Graefes Arch Clin Exp Ophthalmol 2005; 244: 248-252
• 5 Rani PK, Raman R, Bhende P. et al. Visual loss may be due to silicone oil tamponade effect rather than silicone oil removal. Br J Ophthalmol 2005; 89: 1667
• 6 La Cour M, Lux A, Heegaard S. Visusminderung unter Silikon. Klin Monatsbl Augenheilkd 2010; 227: 181-184
• 7 Christensen UC, la Cour M. Visual loss after use of intraocular silicone oil associated with thinning of inner retinal layers. Acta Ophthalmol 2011; 90: 733-737
• 8 Toso A, Cappello E, Morselli S. Unexpected and permanent central visual loss after removal of intraocular silicone oil. Clin Ophthalmol 2014; 8: 1831-1836
• 9 Tode J, Purtskhvanidze K, Oppermann T. et al. Vision loss under silicone oil tamponade. Graefes Arch Clin Exp Ophthalmol 2016; 254: 1465-1471
• 10 Moya R, Chandra A, Banerjee PJ. et al. The incidence of unexplained visual loss following removal of silicone oil. Eye (Lond) 2015; 29: 1477-1482
• 11 Scheerlinck LM, Schellekens PA, Liem AT. et al. Incidence, risk factors, and clinical characteristics of unexplained visual loss after intraocular silicone oil for macula-on retinal detachment. Retina 2016; 36: 342-350
• 12 Lemmen KD, Heimann K. [Early vitrectomy with primary silicone oil injection in very severely injured eyes]. Klin Monatsbl Augenheilkd 1988; 193: 594-601
• 13 Szurman P, Roters S, Grisanti S. et al. Primary silicone oil tamponade in the management of severe intraocular foreign body injuries: an 8-year follow-up. Retina 2007; 27: 304-311
• 14 Kreiger AE, Lewis H. Management of giant retinal tears without scleral buckling. Use of radical dissection of the vitreous base and perfluoro-octane and intraocular tamponade. Ophthalmology 1992; 99: 491-497
• 15 Freeman WR, Quiceno JI, Crapotta JA. et al. Surgical repair of rhegmatogenous retinal detachment in immunosuppressed patients with cytomegalovirus retinitis. Ophthalmology 1992; 99: 466-474
• 16 Brourman ND, Blumenkranz MS, Cox MS. et al. Silicone oil for the treatment of severe proliferative diabetic retinopathy. Ophthalmology 1989; 96: 759-764
• 17 Van Meurs JC, Mertens DA, Peperkamp E. et al. Five-year results of vitrectomy and silicone oil in patients with proliferative vitreoretinopathy. Retina 1993; 13: 285-289
• 18 Lesnoni G, Rossi T, Nistri A. et al. Long-term prognosis after removal of silicone oil. Eur J Ophthalmol 2000; 10: 60-65
• 19 Abrams GW, Azen SP, Barr CC. et al. The incidence of corneal abnormalities in the Silicone Study. Silicone Study Report 7. Arch Ophthalmol 1995; 113: 764-769
• 20 Lemmen KD, Dimopoulos S, Kirchhof B. et al. Keratopathy following pars plana vitrectomy with silicone oil filling. Dev Ophthalmol 1987; 13: 88-98
• 21 Barr CC, Lai MY, Lean JS. et al. Postoperative intraocular pressure abnormalities in the Silicone Study. Silicone Study Report 4. Ophthalmology 1993; 100: 1629-1635
• 22 Zborowski-Gutman L, Treister G, Naveh N. et al. Acute glaucoma following vitrectomy and silicone oil injection. Br J Ophthalmol 1987; 71: 903-906
• 23 Shalchi Z, Mahroo OA, Shunmugam M. et al. Spectral domain optical coherence tomography findings in long-term silicone oil-related visual loss. Retina 2015; 35: 555-563
• 24 Gonvers M, Hornung JP, de Courten C. The effect of liquid silicone on the rabbit retina. Histologic and ultrastructural study. Arch Ophthalmol 1986; 104: 1057-1062
• 25 Kellner U, Foerster MH. Der Einfluß von flüssigem Silikon auf die Funktion des Nervus opticus. Fortschr Ophthalmol 1988; 85: 562-564
• 26 Leaver PK. Vitrectomy and fluid/silicone oil exchange for giant retinal tears: 10-year follow-up. Ger J Ophthalmol 1993; 2: 20-23
• 27 Gabel VP, Kampik A, Burkhardt J. Analysis of intraocularly applied silicone oils of various origins. Graefes Arch Clin Exp Ophthalmol 1987; 225: 160-162
• 28 Kiilgaard JF, Milea D, Løgager V. et al. Cerebral migration of intraocular silicone oil: an MRI study. Acta Ophthalmol 2011; 89: 522-525
• 29 Grzybowski A, Pieczynski J, Ascaso FJ. Neuronal complications of intravitreal silicone oil: an updated review. Acta Ophthalmol 2013; 92: 201-204
• 30 Winter M, Eberhardt W, Scholz C. et al. Failure of potassium siphoning by Müller cells: a new hypothesis of perfluorocarbon liquid-induced retinopathy. Invest Ophthalmol Vis Sci 2000; 41: 256-261
• 31 Scheerlinck LM, Kuiper JJ, Liem AT. et al. Electrolyte composition of retro-oil fluid and silicone oil-related visual loss. Acta Ophthalmol 2016; 94: 449-453
• 32 Hirata A, Yonemura N, Hasumura T. et al. Effect of infusion air pressure on visual field defects after macular hole surgery. Am J Ophthalmol 2000; 130: 611-616
• 33 Kweon EY, Ahn M, Lee DW. et al. Operating microscope light-induced phototoxic maculopathy after transscleral sutured posterior chamber intraocular lens implantation. Retina 2009; 29: 1491-1495