Interaction of Different Ocular Endotamponades as a Risk Factor for Silicone Oil Emulsification

Abstract

Abstract: : Purpose: To investigate possible sources for the induction of silicone oil emulsification in patients' eyes. Methods: 98 emulsified as well as non–emulsified samples of silicone oil explanted at 13 different clinics were analyzed for volatile compounds using gas chromatography coupled mass spectroscopy of the head space (GC/MS/HS). The main focus was on perfluorocarbon liquids used intraoperatively during vitreoretinal surgery, on oligosiloxanes as silicone oil inherent impurities and on organic liquids generally used as cleaning agents. Results: Perfluorocarbons were present in concentrations up to 3700 ppm, partially fluorinated alkanes up to 5000 ppm. Hydrogen peroxide and different alcohols as well as oligosiloxanes could be detected. Conclusions: The intraoperative exchange of perfluorocarbon liquids and silicone oil and the coexistence of silicone oil and aqueous materials in the vitreous cavity during endotamponade are very sensitive systems. Disturbances have to be minimized to maintain the inertness of the silicone oil bubble necessary for a safe and effective endotamponade.

Keywords: vitreous substitutes • vitreoretinal surgery • retinal detachment