Intravitreal silicone oil injection: complications and treatment of 415 consecutive patients

Abstract

Silicone oil injection in conjunction with pars plana vitrectomy was carried out by five surgeons in 415 consecutive patients using the same surgical equipment, the same surgical techniques and the same highly purified silicone oil (viscosity, 5000 mPa.s). Indications for silicone oil injection after vitrectomy included advanced stages of proliferative vitreoretinopathy following rhegmatogenous retinal detachment (49%), severe proliferative diabetic retinopathy (38%), and proliferative vitreoretinopathy following retinal detachment due to ocular trauma (13%). Postoperative complications were noted in a 6- to 30-month follow-up period. Cataractous changes of varying degree were seen in all phakic eyes. Silicone oil entered the anterior chamber in 6% of all phakic and pseudophakic eyes. Subretinal silicone oil was noted in 4%. Other complications associated with the use of intravitreal silicone oil included biomicroscopically visible silicone oil emulsification (0.7%), keratopathy (5.5%), glaucoma (6%), closure of the inferior iridectomy (6%), and reproliferation of epiretinal and subretinal fibrous membranes (40%). We anticipate that the physico-chemical characteristics of the highly purified silicone oil (viscosity, 5000 mPa.s) and the routine performance of an inferior iridectomy in all aphakic eyes had a positive impact on the low incidence of silicone-oil-related complications such as emulsification, keratopathy and secondary glaucoma.

Efficacy and safety of heavy silicone oil Densiron 68® in the treatment of complicated retinal detachment with large inferior retinectomy

“…In our study, total anatomic success at the last follow-up visit was achieved in 25 of the 27 patients (92.5%), which is similar to the previous results reported for the treatment of severe RD with both standard silicone oil [8,12,16,19] and the heavy silicone oils Oxane Hd® and Densiron 68® [9,18,21,22,29,30].…”

A new heavy internal tamponade in vitreoretinal surgery: an in vitro study

“…Vitreoretinal proliferation occurs more frequently in the inferior quadrants, as cells gather in the watery space between the retina and the oil bubble due to the gravity. [5][6][7][8][9] Therefore, there may be a specific role for tamponade agents with a specific gravity higher than that of water. Several heavier-than-water fluorinated silicone oils have been evaluated for intraocular use.…”

Comparative anatomy of the vitreous body in rhesus monkeys and man

“…This assumption seems to be supported by clinical studies on the complications of vitrectomy and the use of intravitreal substitutes, in which the formation of a cataract is a common postoperative finding [8][9][10][11]. In an animal experiment performed by Repka et al [12], cystic macular lesions were observed after intravitreal injection of CBF s gas.…”