CONDENSATION ON THE POSTERIOR SURFACE OF SILICONE INTRAOCULAR LENSES DURING FLUID-AIR EXCHANGE

Purpose: Posterior chamber foldable silicone intraocular lenses (IOLs) are becoming increasingly prevalent in patients undergoing a pars pla na vitrectomy with fluid-air exchange, The authors report an important limitation of foldable silicone IOLs during fluid-air exchanges in pa rs plana vitrectomies. Methods: The charts of 18 pseudophakic patients with foldable silicone IOLs who underwent vitrectomy with fluid-air e xchange by the authors were reviewed. Results: There was a statistical ly significant difference in the occurrence of condensation during flu id-air exchange between the group of patients with a capsulotomy versu s those that did not have a capsulotomy (P = 0.003). Condensation limi ting the view of the retina occurred during fluid-air exchange in 11 o f 11 of the patients with foldable silicone lenses and a capsulotomy. Attempts to remove the condensation with a soft-tipped aspiration cann ula resulted in limited view of the retina for 1 to 2 minutes in 6 of 11 patients. Use of a thin film of silicone oil restored the view in o ne patient. In the presence of an intact posterior capsule, condensati on did not occur on identical foldable silicone IOLs in seven of seven patients. Conclusion: Recognition of the presence of a foldable silic one lens is important when an air-fluid exchange is anticipated. If a capsulotomy is present, the surgeon must be aware that condensation ma y limit the view of the retina severely during and after surgery. Intr aoperatively, the view of the retina usually can be restored in short surgeries by wiping the posterior lens surface with a soft-tipped cann ula, and in more complex surgeries by applying a thin film of silicone oil on the posterior surface of the lens.