الفهرس 
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Abstract
Pars plana vitrectomy with silicone oil tamponade is a successful method of surgical management of the most difficult cases of proliferative diabetic retinopathy and complicated retinal detachments. Silicone oil instilled in the vitreous cavity ensures stability of the eye ball, restores the initial intraocular anatomical relations and slows down further proliferation, it is well tolerated and because of its transparency it enables easier postoperative visualization of the posterior segment of the eye (Jabbour et al., 2018).
Apart from the possible development of band keratopathy, corneal decompensation and cataract formation, one of the major side effects of the silicone oil is secondary intraocular pressure (IOP) elevation (Rhodes et al., 2002). The early detection of the IOP elevation as well as its adequate and timely management contribute to the maintaining of the good postoperative outcome of the vitrectomy and prevent from the progressive and irreversible optic nerve damage and further deterioration of the visual acuity, which along with the pathological process, aggravated by the IOP elevation.
According to the recent studies the IOP elevation after vitrectomy with silicone oil tamponade most frequently occurs in the early postoperative period (Stamper, 2011) and therefore we have tried to establish if there is a significant difference in the IOP values pre and post vitrectomy with silicone oil in group of patients.
Our study done on 35 patients (of age range from 32 to 67 years, 12 female and 23 male, there was right eye involvement in 17 cases and left eye involvement in 18 cases, 10 with PDR and 25 with RD, 23 were phakic and 12 were pseudophakic underwent pars plana vitrectomy (23 gauge) with silicone oil injection (1000 cs)). Intraocular pressures were measured before surgery, then at one day, one week, two weeks, one month, two months and six months after surgery. The results showing that there is clinically significant difference in IOP preoperative and after one day, one week, two weeks postoperative with silicone oil tamponade. First day postoperative mean IOP 18.20 ±3.40 mmHg (range 10.00 – 24.00 mmHg, p <0.000). One week postoperative mean IOP 18.63 ±4.60 mmHg (range 9.00 - 27.00 mmHg, p 0.000). Two weeks postoperative mean IOP 20.69 ±8.94 mmHg (range 8 – 49.00 mmHg, p 0.001). Peak value of IOP was at two weeks after surgery. There were 45.7 % of patients who need medical treatment with antiglaucoma medications. The medical treatment continued in these cases throughout the follow-up period. The IOP measurements at six months after surgery showed that mean IOP values do not differ much from the initial, preoperative values. The mean pre-operative IOP 15.40 ±3.34 mmHg (range 9.00 – 22.00 mmHg). Six months postoperative mean IOP 16.60 ±3.30 mmHg (range 8.00 to 24.00 mmHg). Also the results showing that the early elevation of IOP is equally present in the patients with RD as well as in those with PDR. However, a qualitative analysis of the two groups of patients showed higher IOP in patients with PDR. There was nonsignificant difference in IOP between phakic and pseudophakic groups.
Silicone oil significantly affect visual acuity in both groups of patients at one month, second month and six months postoperative causing mild improvement of the visual acuity wit nonsignificant difference between PDR and RD groups or phakic and pseudophakic groups.
All of these patients required medical treatment with antiglaucoma medications. No patients in this series had uncontrolled IOP.