Silicon oil
● Intraocular tamponade to maintain adhesion between RPE and neurosensory retina
● Hydrophobic, specific gravity (0.97) less than water, refractive index (1.4) higher than
vitreous
● Repeating units of siloxane
● Available in 1000/5000 centistokes
Advantages:
1. High surface tension
2. Ease of removal
3. Low toxicity
4. Immiscible with water
Immiscibility + High surface tension + Low SG = Tamponade effect on superior retina
Preferable to use it when high elevation travel/flight travel is planned Difficulty in maintaining prone positioning
Disadvantages:
● Surface tension less than gas/saline- can pass through retinal breaks under traction more easily than gas
● Hydrophobic - does not have desired retinal contact
● Low SG- tamponade of inferior retina is difficult
● Refractive index needs optical adjustments
● Post-operative cataract formation
● Emulsified SO can adhere to IOL
● Secondary glaucoma
● Corneal decompensation
Indications:
1. RD with PVR- prevents vasoproliferative factor migration, decrease post op hemorrhage
2. Severe PDR- Diabetic TRD
3. Macular hole
4. Giant retinal tears- unfolding the retina
5. Traumatic RD - long term tamponade
6. Those who want to travel by air/ cannot maintain prone positioning
7. Chronic uveitis with profound hypotony
8. Infectious retinitis
9. Endophthalmitis- antibacterial properties
Complications:
1. Emulsification
2. Cataract
3. Secondary glaucoma
4. Band shaped keratopathy
5. Corneal decompensation
6. Recurrent retinal detachment
7. Absorption of SO by silicon intraocular lenses
8. Migration of silicon oil into optic nerve and brain
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