An epidemic of sticky silicone oil at the Rotterdam Eye Hospital. Patient review and chemical analyses.

PURPOSE

To report and study the phenomenon of abnormal silicone oil adherent to the retina at the time of removal in a number of patients.

MATERIALS AND METHODS

Chart review was performed to identify possible patient or procedural factors that could predispose to sticky silicone oil formation. Gas chromatography-mass spectroscopy and nuclear magnetic resonance spectroscopy analyses were performed on sticky silicone oil samples, on perfluorocarbon liquid and on silicone oil samples straight from the vial.

RESULTS

Sticky silicone oil remnants were seen on the retina in 28 out of 234 silicone oil removal procedures between January 2001 and November 2002. Forceful removal was complicated in two patients by a choroidal hemorrhage and in one patient by a retinal tear. The use of perfluoro-octane (PFO; C(8)F(18)) rather than perfluorodecalin (C(10)F(18)) was related to the phenomenon (P < 0.001). Gas chromatography-mass spectroscopy analysis revealed a significant presence of PFO in samples of sticky silicone oil, and traces of partially fluorinated carbon liquid were found in the sticky oil as well as in the PFO samples.

CONCLUSIONS

The use of PFO may have been a predisposing factor for the occurrence of sticky silicone oil. While the presence of silicone oil remnants on the retina did not cause lasting side effect, forceful attempts at removal can lead to complications.