<p>Emulsification of Different Viscosity Silicone Oil in Complicated Retinal Detachment Surgery: A Randomized Double-Blinded Clinical Trial</p>

Abstract

Objective: To study silicone oil (SO) emulsification, anatomic and visual outcome after complicated retinal detachment surgery by pars plana vitrectomy (PPV) with intraocular SO tamponade, comparing between low and high viscosity SO. Design: Randomized, double-blinded, controlled trial. Patients and Methods: Patients with complicated retinal detachment who had been surgically treated by PPV and intraocular SO tamponade were randomly divided into low viscosity (Group 1) or high viscosity (Group 2). Main Outcome Measures were rate of silicone oil emulsification, anatomic retinal reattachment and visual outcome, assessed at 1,3,6,9 and 12 months. Results: One hundred patients were divided into 50 patients in each group. The rate of silicone oil emulsification in Group 1 (63.64%) was higher than Group 2 (40%), but the difference was not statistically significant (p = 0.08). Rates of anatomic retinal reattachment were 88% in Group 1 and 90% in Group 2 (p = 0.76). For functional visual outcome, final best-corrected visual acuity (BCVA) at Month 12 compared with the baseline BCVA was improved vision 52% in Group 1 and 58% in Group 2 (p = 0.82). Conclusion: SO emulsification rate in low viscosity group is non-significantly higher than high viscosity group, but results in a comparable reattachment rate and final visual recovery. Emulsification in both groups is detected at as early as 1 month and mostly within 3 months. We recommend using either low or high viscosity SO in complicated retinal detachment surgery and removing it as early as possible to prevent the consequent serious complications. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02988583.

Intraocular pressure changes during and after silicone oil endotamponade (Review)

“…The results of in vitro studies indicating that higher viscosity is associated with better long-term stability due to a lower rate of emulsification ( 1 , 4 , 27 ) have been contested in real-life. The only randomized, double-blinded, controlled study to date, conducted on patients with complicated retinal detachments, has shown that low viscosity SIO has a non-significant higher rate of emulsification on short and medium-term (up to 6 months) but much higher emulsification rate in endotamponades over this time as compared with higher viscosity SIO ( 28 ). Emulsification is not exclusively related to the physicochemical properties of SIO.…”

“…While emulsification time is believed to largely vary between 5 and 24 months postoperatively ( 32 ), some reports emphasize that first signs of SIO emulsification appear in the first 3 months postoperatively ( 33 ) and even earlier, in the first month postoperatively ( 28 ). Since most of the cases have a certain degree of SIO emulsification within the first year postoperatively, there is a large consensus on the necessity to remove the SIO during this interval.…”

« Hyperpion » de silicone : histoire naturelle et traitement, à propos d’un cas

“…L'émulsification, lorsqu'elle survient, apparaît généralement à partir de trois mois après le tamponnement [5], mais elle peut survenir plus précocement, surtout chez les enfants et les adultes jeunes.…”

Biometric changes after vitrectomy with silicone oil tamponade

“…The viscosity depends on the polymeric compound length and ranges from 1000 to 10000 centistokes (cs). Two types of highly purified polydimethylsiloxanes, low viscosity (1000 or 1300 cs) and high viscosity (5000 or 5700 cs), are commonly used in clinical practice [16]. In this study, 5700 cs SO (Oxane 5700; Bausch & Lomb, Germany) was injected in all patients.…”