CORNEAL ENDOTHELIAL CELL DENSITY AFTER VITRECTOMY WITH SILICONE OIL FOR COMPLEX RETINAL DETACHMENTS

In Brief Purpose: To evaluate the endothelial cell density changes in eyes with silicone oil tamponade after vitrectomy for complex rhegmatogenous retinal detachment. Methods: A prospective controlled study with 81 eyes with complex rhegmatogenous retinal detachment undergoing vitrectomy and silicone oil tamponade. Fellow eyes that fulfilled specific inclusion criteria served as controls. Endothelial cell density (in cells per square millimeter), coefficient of variance (standard deviation per mean cell area × 100), percentage of hexagonal cells, and corneal thickness were documented preoperatively and compared with values obtained at 3, 6, and 12 months postoperatively. For the purpose of the study analysis, all study eyes were divided into 5 groups, according to their lens status during the follow-up. Results: High endothelial cell density loss was found in Group 3, (eyes that underwent an additional phacoemulsification procedure) and Group 4 (eyes that underwent lens and/or intraocular lens removal during the follow-up) at 12 months with a mean cell loss of 19% and 39%, respectively (P < 0.001). Conclusion: An intact natural or artificial lens–iris diaphragm may provide a protective barrier against corneal endothelial cell damage from long-term silicone oil tamponade. In a prospective study, the mean postoperative endothelial cell density after vitrectomy with silicone oil tamponade decreased 39% at 12 months compared with preoperative values in eyes that underwent lens removal during the follow-up.