Irreversible silicone oil adhesion to silicone intraocular lenses. A clinicopathologic analysis.
OBJECTIVE
To report a newly defined complication of foldable intraocular lenses (IOLs), namely silicone oil-silicone IOL interaction. This is a complication not generally seen by the implanting cataract surgeon but, rather, at a later stage in a patient's postoperative course, by a vitreoretinal surgeon.


METHODS
Three clinical case histories, including two explanted silicone IOLs, were submitted for analysis. The submitted silicone lenses were photographed under water, and the nature of the silicone oil coating was documented.


RESULTS
In each instance, the silicone coating was manifest as a thick coating with droplet formation on the lens surface that was tenaciously adherent and could not be dislodged by instruments or injection of viscoelastics.


CONCLUSIONS
The use of silicone IOLs in patients with current vitreoretinal disease or those who are at high risk for future vitreoretinal disease that may require silicone oil as part of the therapy should be reconsidered. The authors recommend that information regarding the existence and significance of this complication be printed on all silicone oil and silicone IOL packages and inserts (if not as a warning, at least as an informative comment regarding the existence of this condition). This is a rare but clinically significant complication that will affect the occasional patient treated with both of these modalities.
Apple
D J
DJ
Department of Ophthalmology and Pathology, Storm Eye Institute, Medical University of South Carolina, Charleston 29425, USA.
Federman
J L
JL
Krolicki
T J
TJ
Sims
J C
JC
Kent
D G
DG
Hamburger
H A
HA
Smiddy
W E
WE
Cox
M S
MS
Hassan
T S
TS
Compton
S M
SM
Thomas
S G
SG
D000328:Adult; D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects*; D005128:Eye Diseases / Q000150:complications; D005260:Female; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012164:Retinal Diseases / Q000150:complications; D012307:Risk Factors; D012826:Silicone Elastomers / Q000378:metabolism*; D012827:Silicone Oils / Q000378:metabolism*; D000267:Tissue Adhesions / Q000209:etiology; D014822:Vitreous Body / Q000473:pathology
D012826:Silicone Elastomers; D012827:Silicone Oils