Safety and efficacy of transpupillary silicone oil removal in combination with micro-incision phacoemulsification cataract surgery: comparison with 23-gauge approach.

Background: To evaluate safety and efficacy of transpupillary silicone oil removal combined with micro-incision phacoemulsification cataract surgery, and to compare results of transpupillary with 23-gauge three-port vitrectomy approach.
Methods: Consecutive cases that underwent silicone oil removal using either transpupillary or three-port approach in combination with micro-incision phacoemulsification cataract surgery were retrospectively reviewed. The main outcome measures were postoperative detachment rate, silicone oil residuals, best corrected visual acuity (BCVA) and intraocular pressure (IOP).
Results: A total of 64 cases were included, 19 in transpupillary and 45 in three-port. Postoperative detachment rate within 3 months in transpupillary versus three-port was 15.8% versus 4.4% (p = 0.14), Silicone oil residuals was 7.4 ± 3.2% versus 7.1 ± 2.8% (transpupillary vs. three-port, p = 0.71). Preoperative versus postoperative BCVA (logMAR) was 1.49 ± 0.61 versus 1.42 ± 0.61 in transpupillary approach (p = 0.28) and 1.53 ± 0.48 versus 1.45 ± 0.57 in three-port approach (p = 0.11). Transpupillary approach resulted in lower IOP at postoperative day 2 (12.2 ± 2.3 mmHg vs. 13.5 ± 2.2 mmHg, p < 0.05), while postoperative follow-up at 1 month revealed no significant difference (p = 0.21).
Conclusions: Transpupillary silicone oil removal combined with micro-incision phacoemulsification cataract surgery is less invasive and can be an alternative in some circumstances.