Cataract surgery and silicone oil removal: visual outcome and complications in a combined vs. two step surgical approach

To compare visual outcome and complications of two surgical strategies for patients who needed cataract surgery and silicone oil removal. A prospective, nonrandomized study was performed to compare two groups of patients who had cataract surgery and silicone oil removal from April 1998 to January 2002. From April 1998 to November 1999, patients had two surgical sessions with cataract surgery before silicone oil removal (Group 1), and from December 1999 to January 2002, patients underwent combined cataract surgery and silicone oil removal in a single session (Group 2). Thirty-five patients were included in each group. The postoperative visual acuity improved by at least two lines of Snellen in 13 patients (37.1%) in Group 1 and 15 (42.8%) patients in Group 2 (P=0.63). The mean visual improvement was 0.12 lines and 0.13 lines in groups 1 and 2 (P=0.62). Complications in groups 1 and 2 included transient intraocular pressure rise (25.7% versus 28.5%), retinal detachment (14.2% versus 11.4%), fibrin reaction (5.7% in both groups), and persistent intraocular pressure rise (2.8% in both groups). The visual outcome and complication rates were similar in both groups. Combined surgery offers the advantages of a single surgical event and a faster visual rehabilitation. We therefore suggest a surgical approach with combined cataract surgery and silicone oil removal in selected patients with a stable retinal situation.