Cystoid Macular Edema Following Silicone Oil Tamponade For Retinal Detachment Surgery

Case Report

Austin J Clin Ophthalmol. 2015;2(1): 1042.

Cystoid Macular Edema Following Silicone Oil Tamponade For Retinal Detachment Surgery

Haider A2, Bababeygy SR1,2* and Lu SY1,2

1Department of Ophthalmology, University of California Irvine, Gavin Herbert Eye Institute, USA

2Irvine School of Medicine, University of California Irvine, USA

*Corresponding author: Bababeygy SR, Department of Ophthalmology, University of California Irvine, Gavin Herbert Eye Institute, Irvine, California, 850 Health Sciences Road, Irvine, CA 92697-4375, USA

Received: January 08, 2015; Accepted: February 26, 2015; Published: February 29, 2015


We report three cases of Cystoid Macula Edema (CME) associated with the use of silicone oil tamponade forretinal detachment (RD) repair. Clinical presentation, age at presentation, detachment severity and visual recovery differed considerably in the three cases. CME developed 1 monthafter silicone oil placement and resolved in 1 month or less after silicone oil removal in all three cases. Visual acuities improved from 20/100 to 20/40, 20/400 to 20/70 and 20/100 to 20/60 in the three cases, respectively. Silicone oil tamponade may be associated with CME formation. The etiology of CME following silicone oil placement is unclear but may involve an inflammatory reaction and/or mechanical traction.

Keywords: Cystoid macular edema; Retinal detachment repair; Silicone oil; Tamponade


BCVA: Best-Corrected Visual Acuities; CME: Cystoid Macular Edema; OD: Right Eye; OS: Left Eye; POM: Post-Operative Month; POW: Post-Operative Week; PVD: Posterior Vitreous Detachment; RD: Retinal Detachment; SRF: Sub-Retinal Fluid


Tamponade agents are needed during surgical repair of retinal detachment (RD) to reduce the rate of postoperative recurrent RD [1]. While gas and silicone oil often have similar clinical outcomes, the selection of tamponade agent is done on an individualized basis, with consideration for factors such as detachment configuration, retinal break location, lens status, patient compliance, need for air travel in the early postoperative period, and surgeon and patient preferences [2].

Most cases of silicone oil removal occur without complication, but adverse outcomes of retinal re-detachment, cataract formation, postoperative keratopathy, elevated intraocular pressure, and intravitreal hemorrhagehave been reported [3]. To the best of our knowledge, we report the first occurrence of Cystoid Macular Edema (CME) associated with surgical RD repair using silicone oil tamponade. The unclear etiology of CME in this setting is explored by examining the clinical reports of the presented cases.

Case Presentations

Case 1

A 73-year-old man presented with a two-day history of new floaters and an episode of photopsia in his right eye (OD). His ocular history was significant for dry macular degenerationand posterior vitreous degeneration in both eyes (OU), and uneventful phacoemulsification and posterior chamber intraocular lens implant OU one year prior. On examination, his best-corrected visual acuities (BCVA) were 20/25 OD. Indirect ophthalmoscopy revealed a shallow inferior-nasal schisis OD without no sub-retinal fluid (SRF), holes or tears. The patient was educated on RD symptoms and scheduled for frequent follow-up appointments. Five days later the patient noticed new flashes of light and increased floaters. His vision was unchanged from prior exam, and fundoscopy revealed new SRF with an inferiornasal RD. Spectralis® OCT (Heidelberg Engineering Inc., Heidelberg, Germany) confirmed these clinical findings (Figure 1A) and the patient subsequently underwent a pars plana vitrectomy with silicone oil tamponade for retinal detachment repair. At post-operative month (POM) 1, BCVA was 20/150 OD, and OCT revealed CME OD (Figure 1B). Silicone oil was removed 2.5 months after the initial vitrectomy. Two weeks after silicone oil removal, BCVA improved to 20/50OD and OCT showed total resolution of the CME (Figure 1C).