Heavy Silicone Oil and Intraocular Inflammation

Abstract

In the past two decades, many advances have been made in vitrectomy instrumentation, surgical techniques, and the use of different tamponade agents. These agents serve close retinal breaks, confine eventual retinal redetachment, and prevent proliferative vitreoretinopathy (PVR). Long-acting gases and silicone oil are effective internal tamponade agents; however, because their specific gravity is lower than that of the vitreous fluid, they may provide adequate support for the superior retina but lack efficacy for the inferior retina, especially when the fill is subtotal. Thus, a specific role may exist for an internal tamponade agent with a higher specific gravity, such as heavy silicone oils (HSOs), Densiron 68, Oxane HD, HWS 45-300, HWS 46-3000, and HeavySil. Some clinical evidence seems to presume that heavy tamponades are more prone to intraocular inflammation than standard silicone if they remain in the eye for several months. In this review, we discuss the fundamental clinical and biochemical/molecular mechanisms involved in the inflammatory response after the use of heavy tamponade: toxicity due to impurities or instability of the agent, direct toxicity and immunogenicity, oil emulsification, and mechanical injury due to gravity. The physical and chemical properties of various HSOs and their efficacy and safety profiles are also described.

Comparative assessment of intraocular inflammation following standard or heavy silicone oil tamponade: a prospective study

“…To date, three groups of heavy tamponades have been introduced into surgical practice: fluorinated silicone oil or fluorosilicone, perfluorocarbon liquids and semifluorinated alkanes, such as perfluorohexyloctane (F 6 H 8 ) (Morescalchi et al. ). Densiron‐68™ is a commonly used solution comprising F 6 H 8 and 5000c silicone oil, with a specific gravity of 1.06 and a viscosity of 1387 mPas.…”

“…According to the evidence reported in the literature, the heavy tamponades are more prone to cause intraocular inflammation compared with standard silicone oil, especially if they remain in the eye for several months (Morescalchi et al. ). Side‐effects of heavy silicone oil (HSO) are associated with the chemical and physical properties of the tamponading compound and are similar to those associated with conventional silicone oil (Semeraro et al.…”

“…However, the inflammation associated with HSO appears to be due to a delayed type IV hypersensitivity reaction and varies greatly because the duration of application significantly affects the level of inflammation in the eye (Morescalchi et al. ).…”

<i>In Vivo</i> Emulsification Analysis of 1000 cs and 5000 cs Silicone Oil after Rhegmatogenous Retinal Detachment Vitrectomy Surgery

“…This condition will cause the silicone oil absorb more surfactants that lead the damage of silicon oil structure [12]. Examination Silicone oil is widely used in surgery are trimethyl siloxy-terminated vitreoretinal SiO, poly-trifluoro propyl-methylsiloxane (FsiO) and the most rarely used polyphenylmethylsiloxane [2].…”

Retinal Toxicity of Medical Devices Used during Vitreoretinal Surgery: A Critical Overview

“…The emulsified SO droplets induce a macrophagic foreign body reaction with phagocytosis of SO emulsion by retinal pigment epithelium cells, that can potentially lead to retinal necrosis [15,39] and they have been also related to the development of glaucoma. One of the easiest ways to decrease emulsification is to increase extensional viscosity by increasing the length of the molecular chain of the compound.…”