Oliveira Ramon Antunes De, Magalhaes Junior Octaviano, Rossi Juan Pablo Dos Santos, Gonçalves Luca Bongiovanni de Miranda, Cavalcanti Gabriel Nunes de Figueiredo, Maia André, Brant Fernandes Rodrigo Antonio, Farah Michel Eid, Maia Mauricio
Department of Ophthalmology, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil.
Retina Clinic, São Paulo, Brazil.
Curr Eye Res. 2025 Apr;50(4):353-361. doi: 10.1080/02713683.2024.2409883. Epub 2024 Oct 9.
Silicone oil (SO) has been used as a vitreous tamponade for decades. Surgical complications such as glaucoma, cataract, or emulsification are well known. Despite that, increasing case reports of unexplained visual loss after SO removal is concerning because there is no treatment available. This article describes practical complications related to SO use and advantages/disadvantages for consideration regarding the choice of a vitreous substitute in practice.
A literature review was conducted for publications related to silicone oil, heavy silicone oil, and vitreous substitutes.
This article summarizes the SO chemical and physical properties including both SO and heavy SO and postoperative complications such as corneal decompensation, glaucoma, hypotony, cataract, optic neuropathy. Surgical complications such as over/underfilling, SO migration/emulsification, sticky SO and proliferative vitreoretinopathy (PVR) simulating epiretinal membranes formation, recurrent retinal detachments, SO unexplained visual loss, and permanent SO, are described. A brief overview on potential vitreous substitutes is presented.
The decision to use SO as vitreous substitute in daily practice is based on the severity of retinal diseases and surgeon experience. SO potential complications must not be underestimated. The pursuit of novel safer vitreous substitutes is imperative.
几十年来，硅油一直被用作玻璃体填充剂。青光眼、白内障或乳化等手术并发症已为人熟知。尽管如此，硅油取出后不明原因视力丧失的病例报告不断增加，令人担忧，因为目前尚无有效的治疗方法。本文描述了与硅油使用相关的实际并发症，以及在实际应用中选择玻璃体替代物时需考虑的优缺点。
对与硅油、重硅油和玻璃体替代物相关的出版物进行了文献综述。
本文总结了硅油的化学和物理性质，包括硅油和重硅油，以及术后并发症，如角膜失代偿、青光眼、低眼压、白内障、视神经病变。描述了手术并发症，如填充过多/过少、硅油迁移/乳化、粘性硅油和模拟视网膜前膜形成的增殖性玻璃体视网膜病变（PVR）、复发性视网膜脱离、硅油不明原因视力丧失和永久性硅油。还简要概述了潜在的玻璃体替代物。
在日常实践中决定使用硅油作为玻璃体替代物是基于视网膜疾病的严重程度和外科医生的经验。硅油的潜在并发症绝不能被低估。寻求新型更安全的玻璃体替代物势在必行。
