Silicone oil vs. gas tamponade in giant retinal tear associated rhegmatogenous retinal detachment: a systematic review and meta-analysis
In brief
Silicone oil and gas achieve similar final reattachment in 619 giant-tear eyes
Across nine studies, final retinal reattachment was similarly successful with silicone oil and gas, with no clear difference in initial success or postoperative complications. Several studies suggested better vision with gas, particularly when the macula was still attached, but the evidence was low to very low certainty, leaving the visual advantage unresolved.
- Journal
- Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Q1)
- Published
- 22 October 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Hashem Abu Serhan, Ayman Musleh, Mohammad Abid, Yara Abukhaled, Mohammad Al Diab Al Azzawi, Akram Kilani, et al.
- PMID
- 42911228
- DOI
- 10.1007/s00417-026-07573-x
Why clinicians should know about it
- Picked for Ophthalmology (paper of the day, 25 October 2026): Compares tamponade strategies for complex retinal detachment
Abstract
PURPOSE: To compare anatomical, visual, and safety outcomes of silicone oil (SO) versus gas tamponade in the surgical management of giant retinal tear (GRT)-associated rhegmatogenous retinal detachment (RRD). METHODS: We conducted a PRISMA-compliant systematic review and meta-analysis with protocol registration in PROSPERO (CRD420251207629). We searched PubMed, Scopus, CENTRAL, Web of Science, and Google Scholar and included studies comparing SO and gas tamponade in GRT-associated retinal detachment with at least 10 eyes per group. We pooled data using random-effects models and reported risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). We assessed risk of bias using RoB 2, NOS, or JBI tools, and evaluated certainty of evidence using GRADE. The primary outcome was anatomical success, assessed as primary and final anatomical success. Secondary outcomes included visual acuity and postoperative complications. RESULTS: Nine studies comprising 619 eyes with GRT-associated RRD were included. Final anatomical success was high and comparable between silicone oil and gas tamponade groups (RR = 1.00; 95% CI, 0.96-1.03; I² = 0%). Primary anatomical success also did not differ significantly between groups (RR = 1.08; 95% CI, 0.98-1.20; P = 0.14; I² = 49%). Most studies reported postoperative visual improvement regardless of tamponade type, while several studies suggested better final visual outcomes with gas tamponade, particularly in macula-on detachments. No significant differences were observed in postoperative complications. Overall certainty of evidence ranged from low to very low. CONCLUSION: SO and gas tamponade achieved comparable anatomical success in GRT-associated retinal detachment. However, gas tamponade may be associated with better visual outcomes without an increased risk of postoperative complications.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.