IRREVERSIBLE SILICONE OIL ADHESION TO SILICONE INTRAOCULAR LENSES - ACLINICOPATHOLOGICAL ANALYSIS

Purpose: To report a newly defined complication of foldable intraocula r 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, inclu ding two explanted silicone IOLs, were submitted for analysis, The sub mitted silicone lenses were photographed under water, and the nature o f the silicone oil coating was documented. Results: In each instance, the silicone coating was manifest as a thick coating with droplet form ation on the lens surface that was tenaciously adherent and could not be dislodged by instruments or injection of viscoelastics. Conclusion: The use of silicone IOLs in patients with current vitreoretinal disea se or those who are at high risk for future vitreoretinal disease that may require silicone oil as part of the therapy should be reconsidere d. The authors recommend that information regarding the existence and significance of this complication be printed on all silicone oil and s ilicone IOL packages and inserts (if not as a warning, at least as an informative comment regarding the existence of this condition). This i s a rare but clinically significant complication that will affect the occasional patient treated with both of these modalities.