Ophthalmology Department, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
I.U. Istanbul Tip Fakultesi Göz Hastalikları AD Capa, Fatih, Istanbul, Turkey.
Int Ophthalmol. 2020 Sep;40(9):2267-2274. doi: 10.1007/s10792-020-01409-1. Epub 2020 May 12.
To report emulsified particles and related complications after removal of silicone oil (SO) by spectral domain-optical coherence tomography (SD-OCT) and fluorescein angiography (FA).
A prospective, single-center investigation was performed using SD-OCT, FA and flare cell photometry measurements to evaluate in a cohort of eyes with emulsified silicone particles after removal of long-term SO tamponade.
Nineteen eyes of the 19 patients with emulsified silicone particles detected in ophthalmoscopic exam were included in the study: 13 (68%) were male, and 6 (31.6%) were female, and their mean age was 52.75 ± 16.06 years. Preoperative diagnoses were rhegmatogenous retinal detachment in all eyes. The mean duration of the silicone oil's presence in the eye was found as 12.63 ± 4.87 (7-26) months. SD-OCT examination postoperatively showed small, round and hyper-reflective structures compatible with emulsified silicone particles on preretinal surface in 7 (36.8%) eyes, intraretinally in 6 (31.6%) eyes and in the vitreous in 12 (63%) eyes. FA imaging demonstrated pearl-like hyper-fluorescence at early and late phases on the large blood vessels in 9 (47.4%) eyes. Late phase hyper-fluorescence due to leakage on the macula was observed in 17 (89.5%) eyes. Diffuse peripheral leakage and hyper-fluorescence was detected in 11 (57.9%) eyes. Flare levels were higher in eyes with emulsified SO compared to unaffected fellow eyes (p < 0.05).
Emulsified silicone particles that remain in the eye may lead to retinal complications and inflammation in addition to their known complications such as keratopathy and glaucoma. The particles that lead to inflammation and presence of inflammation may be examined by imaging methods such as SD-OCT and FA. Removing the SO before emulsification would be suitable for avoiding such complications.
通过谱域光相干断层扫描（SD-OCT）和荧光素血管造影（FA）报告硅油（SO）取出后乳化颗粒及相关并发症。
对 19 例硅油长期填塞取出后出现乳化硅颗粒的患者进行前瞻性单中心研究，采用 SD-OCT、FA 和光细胞测量法评估。
在眼科检查中发现 19 例患者的 19 只眼有乳化硅颗粒：13 例（68%）为男性，6 例（31.6%）为女性，平均年龄为 52.75±16.06 岁。所有眼均为孔源性视网膜脱离术前诊断。硅油在眼内的平均存在时间为 12.63±4.87（7-26）个月。术后 SD-OCT 检查显示 7 只眼（36.8%）前膜上有小而圆的高反射结构，与乳化硅颗粒一致，6 只眼（31.6%）视网膜内，12 只眼（63%）玻璃体内。FA 成像显示 9 只眼（47.4%）大血管早期和晚期呈珍珠样强荧光，17 只眼（89.5%）黄斑区晚期出现渗漏性强荧光。11 只眼（57.9%）出现弥漫性周边渗漏和强荧光。乳化 SO 眼的闪光水平高于未受影响的对侧眼（p<0.05）。
除已知的角膜病变和青光眼等并发症外，留在眼内的乳化硅颗粒可能导致视网膜并发症和炎症。导致炎症和炎症存在的颗粒可以通过 SD-OCT 和 FA 等成像方法进行检查。在乳化前取出 SO 可能更适合避免此类并发症。
