Retinal and Corneal Changes Associated with Intraocular Silicone Oil Tamponade

Abstract

Silicone oils (SO) are used as long-term intraocular tamponades and have an irreplaceable role in vitreoretinal surgery. They can, however, be associated with multiple and potentially severe complications, involving different ocular tissues, in particular retina and cornea. Recent advances in ophthalmic imaging have allowed the precise characterization of retinal and corneal microstructural changes, at a subclinical level. This detailed analysis of SO-related retinal and corneal changes has improved our understanding of their pathogenesis and offer the potential for optimized monitoring and management of patients with SO-filled eyes. This review aims to provide clinicians and ophthalmic scientists with an updated and comprehensive overview of the corneal and retinal changes associated with SO tamponade.

Intravitreal Dexamethasone Implant at the Time of Silicone Oil Removal to Treat Persistent Macular Edema after Rhegmatogenous Retinal Detachment Repair

“…Furthermore, the silicone oil (SO) endotamponade, used in the most challenging cases of RRD or in every case that requires a long-term filling effect [ 8 ], may cause the occurrence of CME [ 9 , 10 ], with an incidence that was estimated between 19.6% and 45% of SO-filled eyes [ 9 , 10 , 11 ]. Furthermore, the duration of SO tamponade can correlate with CME onset [ 9 , 12 , 13 ]. The main pathogenetic mechanisms of SO-related complications involve direct acute cytotoxic effects, chemotaxis of inflammatory cells against SO emulsification, and the accumulation of proinflammatory cytokines in the fluid between SO and the retina [ 9 , 12 , 13 , 14 , 15 ].…”

“…Furthermore, the duration of SO tamponade can correlate with CME onset [ 9 , 12 , 13 ]. The main pathogenetic mechanisms of SO-related complications involve direct acute cytotoxic effects, chemotaxis of inflammatory cells against SO emulsification, and the accumulation of proinflammatory cytokines in the fluid between SO and the retina [ 9 , 12 , 13 , 14 , 15 ].…”

Predictors for Visual Outcome After Silicone Oil Removal in Eyes with Complicated Retinal Detachment

“…Retained SO in the eye, however, leads to emulsification and consequent complications such as cataract, glaucoma, keratopathy, and retinopathy. [4][5][6][7] Therefore, SO is considered a temporary tamponade agent and needs to be removed after a period of stable anatomical attachment. A matched-pair cohort analysis has revealed significantly better visual acuity after oil removal than with oil tamponade.…”

“…3 Therefore, following a period of successful retinal reattachment, silicone oil removal (SOR) is recommended to avoid potential sight-threatening complications. [3][4][5][6][7][8][9][10] Although impressive anatomical success rates (72-96%) after SOR have been reported, only 35-76% of patients achieved visual acuity of ≥20/200. [11][12][13][14][15][16][17][18] Functional success rates are not similar to anatomical success rates due to a variety of factors.…”

Editorial: Imaging in Ophthalmology

“…The detection of tissue microstructural changes, even at the subclinical level, can improve our ability to not only make an appropriate diagnosis, but also to elucidate pathogenetic mechanisms and to plan an appropriate management strategy for several pathological conditions. In this regard, for instance, an analysis of the retinal and corneal changes associated with SO tamponade provided important information on the potential effects of this compound on ocular tissues and facilitated the early detection of complications [12][13][14][15]. This aspect is of great clinical relevance, especially when considering that SO-related complications can be severe and potentially sight-threatening [16].…”