Patient left with bubbles of silicone oil on retina following surgery

BMJ Case Reports authors have described their treatment of a patient in his 50s who had several silicone oil bubbles underneath the retina following surgery for a macular off retinal detachment.

Clinicians highlighted that the patient underwent vitrectomy surgery which was complicated by intraoperative hypotony and suprachoroidal haemorrhage. Due to the complications, silicone oil was inserted as a tamponade.

The day after surgery, silicone bubbles were observed at several locations under the retina, with the largest bubble located at the superotemporal arcade.

The clinicians initially decided to monitor the bubbles to see if they migrated or dispersed.

However, three weeks after surgery, imaging revealed no migration or shrinkage of the silicone bubbles.

“Due to their proximity to the macular and fears regarding possible toxicity to the retina, it was necessary to remove them,” the authors shared.

A small drainage retinotomy was made over the main bubble, and over a large inferior retained oil bubble that was successfully drained.

Imaging seven weeks after the removal of the bubbles revealed that the retina was flat, and the two large subretinal oil bubbles had resolved.

“Thus far, the patient’s vision remains stable and no complications from removal of the subretinal oil have occurred,” the authors concluded.

The patient also shared his perspective as part of the case report: “I was sad that the procedure was not straight forward but felt reassured with the care received and on how it was handled.”

“I am glad to have a reasonable level of vision in this eye after the last operation and that things have worked out well despite the initial hiccup,” he said.