Silicone Oil in the Anterior Chamber
- Silicone oil as a vitreous substitute material has been widely used in the management of complicated forms of retinal detachment requiring vitrectomy such as giant retinal tears, cases complicated by PVR, retinal detachment due to proliferative diabetic retinopathy or ocular trauma.
- When the silicone liquid is injected into an aphakic eye or pseudophakic eye with ruptured posterior capsule, the liquid has access to the anterior segment and corneal complications result, probably because access to nutrients is blocked.
- Clinical complications such as angle-closure or pupillary-block glaucoma, inflammation and keratopathy may also be associated with silicone oil.
- To reduce the risk of pupillary-block glaucoma and to keep the AC free of silicone in aphakic eye:
- Avoid overfilling
- Inferior peripheral iridectomy which allows the silicone globule to return to the vitreous cavity when the patient is prone
- Cataract may eventually develop in phakic eyes because of blocked nutrient diffusion across the posterior lens capsule (incidence usually 6 - 18 months after surgery).
