Scientific Online Resource System

Bulgarian Review of Ophthalmology

Early diagnosis of primary open-angle glaucoma in patients after primary vitrectomy due to rhegmatogenous retinal detachment

Martina Milkovska, Ilian Shandurkov



Intraocular pressure (IOP) elevation is a common complication after vitreoretinal surgery and silicone oil implantation. In some cases, the IOP remains high even after removal of silicone. Risk factors such as higher preoperative values and family history of primary open-angle glaucoma are thought to be important.


The purpose of the study is to suggest that in treatment-refractory secondary glaucoma the presence of an underlying primary open-angle glaucoma is likely at an early preclinical stage.


We followed up 88 consecutively operated patients, who underwent primary vitrectomy and silicone oil implantation for unilateral rhegmatogenous retinal detachment. All patients underwent a complete ophthalmological examination. We followed the dynamics in visual acuity, IOP values, and ophthalmoscopic appearance of the optic disc of the vitrectomised and fellow healthy eye. Standard automated perimetry was performed in patients with persistently elevated IOP.


In 34 patients (38.63%), during the post silicone oil implantation period, several (at least 2) IOP values above 21 mmHg were measured. Nineteen (21.59%) of the patients with secondary glaucoma showed a tendency to maintain high IOP after silicone oil removal. In 5 of them (5.68%), the pressure did not respond satisfactorily to the performed anti-glaucoma interventions. Computer perimetry showed glaucomatous visual field defects in both eyes of these patients, necessitating the inclusion of topical antiglaucoma therapy in the unoperated fellow eye, despite maintaining normal IOP.


In cases of treatment-refractory silicone glaucoma, when the IOP remains elevated after the evacuation of the silicone oil, computer perimetry is mandatory in order to timely diagnose and treat primary open-angle glaucoma in the healthy, unvitrectomised eye.


silicone oil, primary open-angle glaucoma, vitrectomy, refractory secondary glaucoma, retinal detachment, intraocular pressure

Full Text


Nicolai M, Lassandro N, Franceschi A, Rosati A, De Turris S, Pelliccioni P, Pirani V, Mariotti C. Intraocular Pressure Rise Linked to Silicone Oil in Retinal Surgery: A Review. Vision (Basel). 2020;4(3):36. doi: 10.3390/vision4030036.

Ichhpujani P, Jindal A, Jay Katz L. Silicone oil induced glaucoma: a review. Graefes Arch Clin Exp Ophthalmol. 2009;247(12):1585-93. doi: 10.1007/s00417-009-1155-x.

Piltz-Seymour J, Aref AA, Eliassi-Rad B. Elevated intraocular pressure associated with retinal procedures. 2022. Available from:

Cornacel C, Dumitrescu OM, Zaharia AC, Pirvulescu RA, Munteanu M, Tataru CP, Istrate S. Surgical Treatment in Silicone Oil-Associated Glaucoma. Diagnostics (Basel). 2022;12(4):1005. doi: 10.3390/diagnostics12041005.

Soheilian M, Mazareei M, Mohammadpour M, Rahmani B. Comparison of silicon oil removal with various viscosities after complex retinal detachment surgery. BMC Ophthalmol. 2006;6:21. doi: 10.1186/1471-2415-6-21.

Issa R, Xia T, Zarbin MA, Bhagat N. Silicone oil removal: post-operative complications. Eye (Lond). 2020;34(3):537-43. doi: 10.1038/s41433-019-0551-7.

Khodeiry MM, Liu X, Sheheitli H, Sayed MS, Lee RK. Slow coagulation transscleral cyclophotocoagulation for postvitrectomy patients with silicone oil-induced glaucoma. J Glaucoma. 2021;30(9):789-94. doi: 10.1097/IJG.0000000000001893.

De Corral LR, Cohen SB, Peyman GA. Effect of intravitreal silicone oil on intraocular pressure. Ophthalmic Surg. 1987;18:446-449.

Honavar SG, Goyal M, Majji AB, Sen PK, Naduvilath T, Dandona L. Glaucoma after pars plana vitrectomy and silicone oil injection for complicated retinal detachments. Ophthalmology. 1999;106(1):169-76; discussion 177. doi: 10.1016/S0161-6420(99)90017-9

Al-Wadani SF, Abouammoh MA, Abu El-Asrar AM. Visual and anatomical outcomes after silicone oil removal in patients with complex retinal detachment. Int Ophthalmol. 2014;34(3):549-56. doi: 10.1007/s10792-013-9857-9.

Moisseiev E, Ohana O, Gershovitch L, Barak A. Visual prognosis and complications following silicone oil removal. Eur J Ophthalmol. 2013;23(2):236-41. doi: 10.5301/ejo.5000199.



Font Size

About The Authors

Martina Milkovska
VISION Eye Hospital, Sofia

Ilian Shandurkov
VISION Eye Hospital, Sofia