Outer Retinal Optical Coherence Tomography Changes Associated With Intraocular Silicone Oil Administration

<b>Purpose:</b> To describe optical coherence tomography (OCT) changes that occur with silicone oil tamponade that may contribute to vision loss. <b>Methods:</b> A retrospective consecutive cohort study was conducted on patients seen at a single center from 2015 to 2023. Inclusion criteria were patients who underwent pars plana vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment repair. <b>Results:</b> Thirteen patients met the inclusion criteria. In the macula-on group, average visual acuity (VA) was 20/60 (0.47 logMAR) while oil was in the eye, and at last follow-up following oil removal, was 20/30 (0.18 logMAR). Seven of 8 patients had resolved OCT outer retinal changes on oil removal. There was a significant improvement in vision with oil removal in comparison with VA prior to oil removal (<i>P</i> = .04). In the macula-off detachment group, patients' average VA prior to surgery with silicone oil was 20/400 (1.5 logMAR). Average VA was 20/400 (1.4 logMAR) during silicone oil tamponade, and at last follow-up, was 20/80 (0.61 logMAR). After oil removal, all OCT outer retinal changes resolved without improvement in vision compared with before oil removal (<i>P</i> = .057). <b>Conclusions:</b> We report outer retinal OCT changes with a subsequent decline in VA. More than 90% of these changes resolved, and VA improved following oil removal. Timely removal upon identification of these changes may improve final visual outcomes, depending on macular detachment status on presentation.