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J. F. Kiilgaard, D. Milea, V. Løgager, M. la Cour; Cerebral Magnetic Resonance Imaging Findings After Intraocular Silicone Oil Injection. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5760.
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Silicone oil is an effective, widespread method to obtain tamponade in vitreoretinal surgery. Very rarely, intraocular silicone oil has been reported to migrate into the optic nerve or other cerebral structures, namely ventricles, leading sometimes to neurosurgical procedures. However little is known about the magnitude of such a potential problem, since only few, single cases have been reported. The aim of our prospective study was to determine the frequency of such complications in a consecutive series of 20 patients operated for retinal detachment and using intraocular silicone oil.
Patients included in this study were referred for silicone oil removal after uncomplicated retinal detachment surgery using internal silicone oil tamponade. Patients with previous history of intraocular silicone oil, glaucoma or optic pit were excluded. After informed consent, the included patients underwent magnetic resonance imaging (MRI) with especially dedicated sequences in order to detect silicone oil migration into the visual pathways or intracranially. Fat saturation as well as STIR sequences combined with water saturation (TR 6686 ms) allowed silicone oil to be visible and easily detectable.
We report the results obtained in the first 6 patients enrolled in this ongoing prospective study. None of these first 6 patients was detected with silicone oil migration into the visual pathways or intracranially. MRI detected only in one patient an intraorbital, parabulbar silicone oil droplet of probable per operative origin. An old intracranial bleeding was incidentally found in one patient. MRI was normal in the remaining four patients.
Specially dedicated MRI sequencies are able to acurately visualise intraocular silicone oil and to detect extraocular silicone droplets. In this peliminary report, none of the included patients had intracranial silicone oil diffusion, suggesting that its occurrence may be very rare, maybe only in patients with optic nerve head anatomical predispositions.
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