Treatment of primary Inferior rhegmatogenous retinal detachment with heavy silicone oil versus standard silicone oil: A meta-analysis

Purpose This study investigates if heavy silicone oil (HSO) is associated with better outcomes than standard silicone oil (SO) as a tamponade agent in the repair of primary inferior rhegmatogenous retinal detachments (RRD). Methods Pubmed, Embase, and Scopus were searched on 4 December 2024 for randomized clinical trials, cohort studies, or case-control studies that compared HSO to SO in patients with primary inferior RRD and reported postsurgical visual acuity (VA) or primary anatomical success defined as retinal reattachment rates after silicone oil removal. Results The analysis included three studies with 529 eyes in the analysis of primary anatomical success and 590 eyes in the analysis of postsurgical visual acuity. The meta-analysis of anatomical success showed a statistically significant difference in the HSO group compared to the SO group, favoring HSO ( RR = 1.25; 95% CI: 1.12–1.39; P < 0.0001). The meta-analysis of postoperative visual acuity yielded no statistically significant differences between the HSO group compared to the SO group (WMD = −0.01; 95% CI: −0.28–0.25; P = 0.93). Conclusion This meta-analysis of one RCT and two observational studies found low-certainty evidence that suggests a higher rate of primary anatomical success in primary inferior RRDs using HSO as a tamponade agent compared with SO. More studies are required to bolster the strength of this conclusion.