This 70 YO male presented with 2 months of blurred vision in his right eye. Vision was counting fingers OD and 20/20 in his normal OS. There was a history of a prior retinal detachment that was repaired with vitrectomy and silicone oil. Removal of the silicone oil, along with combined cataract surgery with a hydrophilic intraocular lens (IOL), was performed 6 months earlier.
Slit lamp photography shows a honeycomb pattern of adherent silicone oil bubbles along the intact posterior capsule.
Learning Points:
Intravitreal silicone oil droplets can irreversibly adhere to the surface of IOLs, particularly silicone lenses, where they can cause significant glare and vision loss (Apple et al, Ophthalmology 1996;103:1555-1562). Silicone oil can also rarely cause IOL opacification (Oner et al, Ophthalmic Lasers Imaging Retina 2021;52:37-43). The adherent oil cannot be removed, and these lenses often require explantation.
Our case is somewhat unique in that the oil droplets adhered to the posterior capsule rather than the IOL. YAG capsulotomy displaced the oil bubbles, and vision improved to 20/60.
