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J. Singh, T. Fallon, G.C. Vafidis; Are Silicone Intraocular Lenses Contraindicated in Diabetic Eyes? . Invest. Ophthalmol. Vis. Sci. 2004;45(13):332.
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Purpose:Many factors guide the choice of intraocular lens (IOL) style and material in cataract surgery. Our aim was to determine whether silicone oil: silicone IOL interactions had occurred in our patients and whether the risk could be considered to contraindicate the use of these lenses in diabetic patients. Methods:We reviewed the case records of all diabetic patients undergoing vitrectomy over a 10 year period in an urban eye unit monitoring 1500 diabetic patients annually. The cataract surgery rate was estimated from the operating log of the same time period. Use of silicone oil, length of time in the eye, presence of IOL and whether intact posterior capsule were noted. Results:Vitrectomy was performed in 79 eyes of 73 patients over 10 years (0.53% of all monitored diabetic patients), for vitreous haemorrhage, tractional retinal detachment and rhegmatogenous retinal detachment. The rate of cataract surgery using silicone IOLs was 5% of all diabetic eyes (150/3000 eyes per year). Silicone oil was used in 14% of all diabetic eyes undergoing vitrectomy (11/79), in treating chronic retinal detachment, or following segmentation/delamination. Three eyes with silicone oil (27%) had silicone IOLs in situ. Oil was removed after 8 months in one, and is still in situ after 12 months and 48 months in two other eyes. All eyes have clear axes. Two have an intact posterior capsule, the third eye underwent capsulotomy at 1 year. No eye has developed complications related to the oil. Conclusions:In our unit the risk of an adverse reaction from silicone oil: silicone IOL interaction appears to be small, despite a 14% rate of silicone oil use in diabetic eyes, and a rate of cataract surgery in keeping with the national average. Though there are abundant case reports of interactions in clinical practice we do not feel that the risk justifies contraindicating this IOL use in diabetic patients.
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