Eight years earlier, this 42YO female underwent successful retinal reattachment surgery elsewhere with scleral buckling, vitrectomy, and silicone oil. Vision was light perception.
Optos imaging shows extensive droplets of emulsified silicone oil.
We decided to observe our patient due to the long history of profound vision loss in a pain-free eye.
Learning Points:
Silicone oil as an adjunct for repairing complex retinal detachments was introduced by Paul Cibis in the early 1960s (Cibis et al, Arch Ophthalmol 1962;68:590-599). It is used primarily for complex detachments at high risk of failure, including severe proliferative vitreoretinopathy and viral retinitis.
Although silicone oil is generally well-tolerated as a long-term tamponade, it can rarely emulsify, resulting in numerous tiny opaque droplets.
The development of emulsification is multifactorial, including the properties of the oil, the surgical procedure, and postoperative factors.
When severe, the emulsified droplets can cause significant vision loss and may require removal. The droplets can also migrate into the anterior chamber, causing a ‘reverse hypopyon’ with secondary elevated intraocular pressure or corneal decompensation.
