A four-year retrospective surgical case series examining postoperative complications following Removal of Silicone Oil (ROSO) scored using the Complications of Retinal Detachment Surgery (CORDS) severity classification tool.

Purpose

Silicone oil (SO) tamponade and the removal of silicone oil (ROSO) in the management of complex retinal detachments carry well-defined postoperative complications. Our objective was to classify and grade complications following ROSO using the Complications of Retinal Detachment Surgery (CORDS) Severity Classification and to propose a unifying proof-of-concept complication score.

Methods

A single-centre retrospective case series of eyes undergoing ROSO was performed between 2018 and 2022. All patient data were collected with 12-month follow-up. Best recorded visual acuity (BRVA, LogMAR), intraocular pressure (IOP, mmHg) and complications were recorded from electronic patient records (EPR). Complications were scored using the CORDS Severity Classification. A Modified Global Complication Score (MGCS) was calculated for our study cohort.

Results

SO was removed from 46 eyes with a mean (SD) tamponade duration of 8.2 (6.61) months. A total of 88 de-duplicated CORDS items were recorded over the 12-month follow-up. Serious complications included anterior displacement of SO (12.5%), retinal re-detachment (5.68%), raised IOP requiring treatment (14.8%), severe loss of vision (18.9%), corneal decompensation (5.68%) and phthisis (2.27%). There was a statistically significant effect of timepoint on mean complication scores (χ² [3] = 11.22, P = 0.011); the effect greatest between the 3-month and 6-month timepoints (P = 0.002). The MGCS was 9.66% for our cohort.

Conclusion

Postoperative complications following ROSO are common with high severity complications, such as secondary glaucoma, corneal decompensation and phthisis, emerging at 3-6 months. Our study proposes the MGCS as an exploratory comparison measure between future studies, but requires further validation in larger prospective cohorts that apply the CORDS Severity Classification.