Silicone oil in vitreoretinal surgery: indications, complications, new developments and alternative long‐term tamponade agents

Chen, Ying; Kearns, Victoria; Zhou, Liangyu; Sandinha, Teresa; Lam, Wai Ching; Steel, David; Chan, Yau Kei

doi:10.1111/aos.14604

Cited by 55 publications

(50 citation statements)

References 132 publications

(179 reference statements)

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“…SilOil has been used as a long-term endo-ocular tamponade agent since 1962, and is still currently indispensable in the treatment of complicated vitreoretinal diseases [ 20 ]. However, the long-term presence of SilOil in the vitreous cavity may cause a variety of complications, especially retinal toxicity.…”

Section: Discussionmentioning

confidence: 99%

“…Four linear LMWCs, namely methyldisiloxane (L2) (#52630, MW = 162.38), octamethyltrisiloxane (L3) (#469319, MW = 236.53), decamethyltetrasiloxane (L4) (#235679, MW = 310.69), dodecamethylpentasiloxane (L5) (#447269, MW = 384.84) and two cyclic LMWCs, octamethylcyclotetrasiloxane (D4) (#235695, MW = 296.62) and decamethylcyclopentasiloxane (D5) (#444278, MW = 370.77) were tested in this study. Silicone oil with a viscosity of 1000 cSt is one of the most commonly used SilOils in ophthalmic surgeries [ 20 ]. Therefore, silicone oil 1000 cSt (1000 cSt SilOil) was used as the control SilOil (#378399).…”

Section: Methodsmentioning

confidence: 99%

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What Is the Cause of Toxicity of Silicone Oil?

Chen

Zhou

et al. 2021

Materials

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Purpose: To investigate the toxicity of the low-molecular-weight components (LMWCs) in ophthalmic silicone oils (SilOils) on retinal cell lines. Methods: The toxicity of six types of LMWCs were studied and compared with conventional SilOil 1000 cSt. In vitro cytotoxic tests of LMWCs, in both liquid and emulsified forms, on three retinal cell lines (Müller cells (rMC-1), photoreceptor cells (661W) and retinal pigment epithelial cells (ARPE-19)) were conducted using a transwell cell culturing system. The morphology and viability of cells were assessed by light microscopy and Cell Counting Kit-8 (CCK-8) assay at different time points (6, 24 and 72 h). The ARPE-19 apoptotic pathway was investigated by Mitochondrial Membrane Potential/Annexin V Apoptosis Kit at different time points (6, 24 and 72 h). Results: Apart from dodecamethylpentasiloxane (L5), all liquid LMWCs showed varying degrees of acute cytotoxicity on retinal cell lines within 72 h. Emulsified LMWCs showed comparable cytotoxicity with liquid LMWCs on retinal cell lines. Cyclic LMWCs, octamethylcyclotetrasiloxane (D4) and decamethylcyclopentasiloxane (D5) had significantly higher cytotoxicity when compared with their linear counterparts decamethyltetrasiloxane (L4) and L5 with similar molecular formula. Using ARPE-19 cells as an example, we showed that LMWCs induce the apoptosis of retinal cells. Conclusions: Most LMWCs, in both liquid and emulsified forms, can induce acute cytotoxicity. In addition, cyclic LMWCs are suspected to have higher cytotoxicity than their linear counterparts. Therefore, LMWCs are suspected to be the main cause of the long-term toxicity of ophthalmic SilOil, due to their toxicity and propensity to cause ophthalmic SilOil to emulsify. The amount of LMWCs should be considered as the paramount parameter when referring to the quality of SilOil.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

What Is the Cause of Toxicity of Silicone Oil?

Chen

Zhou

et al. 2021

Materials

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“…However, several complications arise with the long-term use of SO as vitreous substitute which includes its emulsification resulting in cataract formation, glaucoma, corneal toxicity, band keratopathy [ 60 , 61 ]. In order to avoid these complications, surgical removal of silicone oil becomes a necessity, although risk of retinal detachment is associated with the removal process.…”

Section: Currently Used Vitreous Substitutes In Clinicsmentioning

confidence: 99%

Substitutes and Colloidal System for Vitreous Replacement and Drug Delivery: Recent Progress and Future Prospective

2020

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Vitreoretinal surgeries for ocular diseases such as complicated retinal detachment, diabetic retinopathy, macular holes and ocular trauma has led to the development of various tamponades over the years in search for an ideal vitreous substitute. Current clinically used tamponade agents such as air, perfluorocarbons, silicone oil and expansile gases serve only as a short-term solution and harbors various disadvantages. However, an ideal long-term substitute is yet to be discovered and recent research emphasizes on the potential of polymeric hydrogels as an ideal vitreous substitute. This review highlights the recent progress in the field of vitreous substitution. Suitability and adverse effects of various tamponade agents in present day clinical use and biomaterials in the experimental phase have been outlined and discussed. In addition, we introduced the anatomy and functions of the native vitreous body and the pathological conditions which require vitreous replacement.

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“… 3 Repeated retinal detachment will lead to SO dependence, 4 which requires extended maintenance of the prone position. Long-term SO tamponade can lead to complications such as corneal degeneration, emulsification, cataracts, 5 , 6 early hypertension, and secondary glaucoma. 7 , 8 Studies concerning the effects of long-term SO tamponade on intraocular pressure (IOP) have implied that this treatment may lead to reduced choroidal thickness; 9 – 11 SO‐related retinal toxicity and visual loss have also been observed.…”

Section: Introductionmentioning

confidence: 99%

“… 6 , 12 SO emulsification is the most important limitation of long-term in situ SO tamponade because it is considered a fundamental source of SO-related complications. 5 Emulsification is associated with the development of keratopathy, delayed glaucoma, and optic neuropathy through mechanisms including emulsion oil droplet contact with the corneal endothelium, trabecular network inflammation, and direct SO infiltration into the atrial angular structure. Despite its complications, SO tamponade remains suitable for patients with severe ocular trauma.…”

Section: Introductionmentioning

confidence: 99%

Foldable capsular vitreous body implantation for treatment of traumatic retinal detachment: two case reports

et al. 2021

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Retinal detachment caused by severe ocular trauma is a type of refractory vitreoretinal disease. Current treatment methods include vitrectomy combined with silicone oil tamponade. However, long-term use of silicone oil tamponade has various complications, including a risk of silicone oil dependence that eventually leads to eyeball atrophy and enucleation. Foldable capsular vitreous bodies (FCVBs) offer a good solution for these problems. However, FCVBs have not been used in large-scale clinical applications and few cases have been reported in the published literature. The main use of FCVBs, based on current evidence, is in the treatment of the relatively few (but important) patients whose eyes have no visual potential; the aim of treatment in these patients is globe preservation, rather than restoration of vision. Here, we describe two patients who underwent FCVB implantation. The findings in these patients indicated that FCVBs can effectively support the vitreous cavity and detached retina. FCVB implantation may thus offer a safe and effective method for treatment of severe retinal detachment, avoiding the inconvenience caused by silicone oil dependence and enucleation. To confirm its long-term usefulness in clinical applications, many additional case reports are needed.

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Silicone oil in vitreoretinal surgery: indications, complications, new developments and alternative long‐term tamponade agents

Cited by 55 publications

References 132 publications

What Is the Cause of Toxicity of Silicone Oil?

What Is the Cause of Toxicity of Silicone Oil?

Substitutes and Colloidal System for Vitreous Replacement and Drug Delivery: Recent Progress and Future Prospective

Foldable capsular vitreous body implantation for treatment of traumatic retinal detachment: two case reports

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