Heidenkummer H P, Kampik A, Thierfelder S
University Eye Hospital, Würzburg, Germany.
Retina. 1992;12(3 Suppl):S28-32. doi: 10.1097/00006982-199212031-00007.
One of the main problems in the clinical use of silicone oil in vitreoretinal surgery is the instability of the material in terms of emulsification. Fine silicone oil droplets can cause a secondary glaucoma by blocking aqueous outflow. Intravitreally applicable silicone oils comprise an inhomogeneous group of materials, and the rate of emulsification depends on the physicochemical properties of the silicone oils. Clinically most frequently used silicone oils are highly purified polydimethylsiloxanes with a viscosity of 1000 centistokes (cs) to 5000 cs. Low-viscosity silicone oils are preferred by some surgeons because of easier surgical handling and easier removal out of the vitreous. The authors investigated highly purified polydimethylsiloxanes in viscosity ranges of 1000 cs, 2000 cs, 3000 cs, 4000 cs, and 5000 cs with regard to their in vitro stability to evaluate the optimal range of viscosity with acceptable material stability. The comparative stability tests were performed with 0.1% salt solutions of albumin, acidic alpha-1-glycoprotein, fibrin, fibrinogen, gamma globulins, and very-low-density lipoprotein as emulsifiers. Silicone oil at 5000 cs was in all cases distinctly more stable than the silicone oils with a viscosity up to 4000 cs. A positive correlation between the degree of viscosity and an increase of material stability was not found with all emulsifiers. When very-low-density lipoprotein, albumin, and fibrin served as detergents, a remarkable stability gain was achieved only at 5000 cs.(ABSTRACT TRUNCATED AT 250 WORDS)
硅油在玻璃体视网膜手术临床应用中的主要问题之一是材料在乳化方面的不稳定性。细小的硅油滴可通过阻塞房水流出导致继发性青光眼。玻璃体内可应用的硅油材料种类不均一，乳化速率取决于硅油的物理化学性质。临床上最常用的硅油是粘度为1000厘沲（cs）至5000 cs的高度纯化的聚二甲基硅氧烷。一些外科医生更喜欢低粘度硅油，因为手术操作更简便，且更容易从玻璃体中取出。作者研究了粘度范围为1000 cs、2000 cs、3000 cs、4000 cs和5000 cs的高度纯化聚二甲基硅氧烷的体外稳定性，以评估具有可接受材料稳定性的最佳粘度范围。使用白蛋白、酸性α-1-糖蛋白、纤维蛋白、纤维蛋白原、γ球蛋白和极低密度脂蛋白的0.1%盐溶液作为乳化剂进行了比较稳定性试验。5000 cs的硅油在所有情况下都明显比粘度高达4000 cs的硅油更稳定。并非所有乳化剂都发现粘度程度与材料稳定性增加之间存在正相关。当极低密度脂蛋白、白蛋白和纤维蛋白用作去污剂时，仅在5000 cs时才实现了显著的稳定性提高。（摘要截短于250字）
