Carbon dioxide laser-induced combustion of extravasated intraocular silicone oil in the eyelid mimicking xanthelasma.

A 48-year-old woman with a history of retinal detachment repair with vitrectomy, scleral buckling, and silicone oil with subsequent oil removal was referred for unilateral upper eyelid ptosis with edema and overlying skin changes simulating xanthelasma. During surgical excision, a white flare-like plume was noted when the carbon dioxide (CO2) laser was used to make the incisions. The pathology report confirmed silicone oil intrusion in the conjunctiva and upper eyelid. A postoperative in vitro experiment showed that silicone oil was readily ignited by the CO2 laser.