Short and long term exposure of intraocular lenses to silicone oil after vitrectomy and silicone oil tamponade

Purpose: Silicone oil is frequently used as a vitreous substitute after complex vitreoretinal procedures. We sought to study the effect of short and long term exposure to silicone oil on polymethylmethacrylate (PMMA[Alcon MC60BM1), silicone (AMO SI-30NB) and soft acrylic (Alcon MA60BM) intraocular lenses (lOLs). Methods: Forty-one rabbits underwent lensectomy, vitrectomy, lens implantation and capsulotomy followed by fluid-air exchange. All lenses were weighed prior to implantation and 24 hours after explantation. For the short term study, the posterior lens surface was coated with 0.1 ml silicone oil (1000 centistokes). Immediately thereafter, an air-fluid exchange was performed and remaining silicone on the posterior lens surface was aspirated and/or wiped for l min with a 19 gauge soil-tipped extrusion cannula. For the long-term study, the posterior segment was filled with silicone oil after fluid-air exchange. At 3 mos, all animals underwent silicone-fluid exchange, an attempt to manually remove remaining silicone oil, and lens explantation. Results; In the short term study, silicone remained on 0 of 4 PMMA and acrylic lOLs and on 4 of 4 silicone lOLs (p<0.01 for silicone vs. acrylic and silicone vs. PMMA). In the long term study, silicone oil remained on 2 of 9 PMMA lOLs, 0 of 10 acrylic lOLs and 10 of 10 silicone lOLs (p<0.01 for silicone vs. acrylic and silicone vs. PMMA). There was a significant increase in the weight of silicone lOLs after 3 mos, but not in the groups receiving PMMA or acrylic lenses (p<0.01 for silicone vs. acrylic and silicone vs. PMMA). Conclusions: Silicone oil is difficult or impossible to remove from the surface of a silicone IOL. Residual silicone oil on an IOL may interfere with visualization of fundus details and affect the patient's ultimate visual acuity. Acrylic or PMMA lOLs are recommended when choosing an IOL for implantation at the time of cataract surgery in patients at high risk for undergoing vitreoretinal procedures with silicone oil tamponade. C5(JK, GJ) E(RL).

Duke Scholars

Author Glenn Jay Jaffe Ophthalmology, Vitreoretinal Diseases & Surgery