Retrospective Analysis On The Visual And Refractive Outcomes Following Combined Removal Of Silicone Oil (Roso) And Cataract Surgery

To evaluate the visual and refractive outcomes following combined removal of silicone oil (ROSO) and cataract surgery

Tertiary referral centre at Kingston Hospital NHS Foundation Trust, London 

This is a retrospective case series including 28 eyes in 28 consecutive patients who underwent combined cataract extraction and ROSO between April 2018 and January 2024. Electronic patient records were used to obtain and analyse patient demographics, biometry data, visual and refractive outcomes and complications. IOL calculations were performed using the IOLMaster 500 and IOLMaster 700. The spherical equivalent (SE) prediction error was calculated as the difference between the postoperative spherical equivalent and the predicted postoperative target. All eyes underwent standard phacoemulsification and 3-port pars plana vitrectomy surgery to remove silicone oil.

The mean age of patients is 64.93 ± 15.22 and 12 (42.86%) were male. 1300cs SO was used in all eyes with available data (25/28). The mean axial length was 25.30 ± 1.84mm. The best recorded visual acuity (BRVA) improved in 25 eyes (89.3%) with a mean improvement of -0.7171 LogMAR (p<0.01). BRVA of 6/18 or better was achieved in more than one-third of eyes and 14 eyes (50%) gained 2 or more lines of BRVA. The mean SE prediction error is +0.64 (95% CI -0.0206 to 1.3062, p=0.0570). Prediction errors within ±0.25D, ±0.50D and ±1.00D were found in 5 eyes (20%), 8 eyes (32%) and 14 eyes (56%) respectively. The most common postoperative complication was cystoid macular edema (n=11, 39.3%) and recurrent retinal detachment (n=10, 35.7%).

Combined ROSO and cataract surgery is an effective procedure to improve visual acuity. We recommend a target refraction of -0.50D to -0.75D to offset the undercorrection or hyperopic SE prediction error when targeting emmetropia using modern biometers in patients with 1300cs silicone oil.