Retinal Nerve Fiber Layer Changes Following Primary Retinal Detachment Repair with Silicone Oil Tamponade and Subsequent Oil Removal

Purpose: To evaluate the correlation between the retinal nerve fiber layer (RNFL), particularly the temporal RNFL (TRNFL), and visual outcomes following surgery for rhegmatogenous retinal detachment (RRD). Methods: This retrospective study was performed at a tertiary center; 32 patients underwent single and successful vitrectomy for total RRD using silicone oil as tamponade. Data were collected after oil removal. RNFL thickness and central foveal thickness (CFT) were measured using spectral domain optical coherence tomography. RNFL thickness and CFT of normal eyes were acquired as a control to calculate percentage changes in the affected eyes. The correlation between postoperative best‑corrected visual acuity (BCVA) and TRNFL changes was the primary outcome measure. Results: Postoperative BCVA correlated negatively with retinal detachment (RD) duration (Pearson coefficient 0.56, P = 0.001) and percentage loss in TRNFL thickness (Pearson Coefficient 0.41, P = 0.02). The macula lost the maximum RNFL thickness (26%). The mean percentage loss of TRNFL was significantly higher in patients with postoperative BCVA <6/60 (42.63% vs. 24.06%, P = 0.009). Patients with postoperative BCVA <6/60 had a significantly longer mean RD duration (29 days) than those with postoperative BCVA >6/60 (17.5 days) (P = 0.026). Conclusion: When eyes with RRD are successfully repaired using silicone oil tamponade, the thickness of the RNFL decreases, particularly in the macula, and less macular neuronal loss is associated with better visual outcomes.