Dick B, Stoffelns B, Pavlovic S, Schwenn O, Pfeiffer N
Universitäts-Augenklinik Mainz.
Klin Monbl Augenheilkd. 1997 Sep;211(3):192-206. doi: 10.1055/s-2008-1035121.
Silicone oil is increasingly used as an intravitreal tamponade in severe forms of vitreoretinal disorders, also in pseudophakic eyes. In some patients silicone oil was observed to be adherent to the intraocular implant.
To investigate the interaction of silicone oil with IOL-materials and the influence of lipoproteins of the serum on this interaction we used the following in vitro experimental set-up: Sterile IOLs of different IOL-materials (e.g. PMMA, silicone, hydrogel) and surface-modifications (e.g. Pharmacia 809P and 809C, Soflex LI41U, Alcon AcrySof M60BM, Allergan SI-30NB, SI-40NB, Chiron adatomed 90D, C10 and C31UB, MemoryLens U940A, Corneal ISHEMA 66, Storz H60M) were stored in vitro together with silicone oil (1000 centistokes) with and without a fresh serum solution at 37 degrees Celsius. This combination was rotated slowly and mixed thoroughly three times a day. After 3 and 6 months and a standardized special preparation in an ultrasound bath and air treatment, the IOLs were examined by light microscopy followed by scanning electron microscopy.
Silicone oil strongly adhered to holes and to the IOL surface especially in silicone and PMMA IOLs. Highly hydrophylic IOLs-like the heparin-surface-modified and hydrogel IOL-cleared from silicone oil relatively early. This effect was more pronounced in the group with lipid-/serum solution than without. In some silicone IOLs silicone oil was strongly adherent to the lens and it was nearly impossible to wash off the oil even when using an alcoholic solution. One silicone IOL lost its haptics in the serum-oil-IOL-mixture, another lost small particles from the IOL surface.
Silicone oil is more adherent to hydrophobic IOLs than to hydrophylic IOLs. Lipoproteins of the serum play an important role in facilitating an effect of silicone oil on IOL materials. We recommend highly hydrophylic especially surface-modified IOLs for lens implantation following vitreoretinal silicone oil surgery. Implantation of silicone IOLs in vitreoretinal high risk eyes should be avoided.
硅油越来越多地被用作严重玻璃体视网膜疾病的玻璃体腔内填塞物,在人工晶状体眼也有应用。在一些患者中,观察到硅油附着于眼内植入物。
为研究硅油与人工晶状体材料的相互作用以及血清脂蛋白对这种相互作用的影响,我们采用了以下体外实验装置:将不同人工晶状体材料(如聚甲基丙烯酸甲酯、硅酮、水凝胶)和表面改性(如法玛西亚809P和809C、索夫利克斯LI41U、爱尔康AcrySof M60BM、眼力健SI - 30NB、SI - 40NB、凯龙表面修饰90D、C10和C31UB、记忆晶状体U940A、角膜ISHEMA 66、史托斯H60M)的无菌人工晶状体与硅油(1000厘沲)一起,在有和没有新鲜血清溶液的情况下,于37摄氏度体外储存。这种组合每天缓慢旋转并充分混合三次。3个月和6个月后,在超声浴中进行标准化特殊处理并经过空气处理后,先用光学显微镜然后用扫描电子显微镜检查人工晶状体。
硅油强烈附着于人工晶状体的孔和表面,尤其是硅酮和聚甲基丙烯酸甲酯人工晶状体。高度亲水的人工晶状体,如肝素表面改性和水凝胶人工晶状体,相对较早地清除了硅油。在有脂质/血清溶液的组中这种效果比没有时更明显。在一些硅酮人工晶状体中,硅油强烈附着于晶状体,即使使用酒精溶液也几乎不可能洗掉硅油。一个硅酮人工晶状体在血清 - 油 - 人工晶状体混合物中失去了其袢,另一个从人工晶状体表面脱落了小颗粒。
硅油对疏水人工晶状体的附着力比对亲水人工晶状体更强。血清脂蛋白在促进硅油对人工晶状体材料的作用方面起重要作用。我们建议在玻璃体视网膜硅油手术后植入晶状体时使用高度亲水尤其是表面改性的人工晶状体。应避免在玻璃体视网膜高危眼中植入硅酮人工晶状体。