SILICONE OIL IN THE ANTERIOR-CHAMBER

Background One reason for complications after silicone oil application is the postoperative entrance of silicone oil into the anterior chamb er. In a retrospective study, we tried to define risk factors for oil entrance into the anterior chamber. Methods 159 Eyes of 148 patients, vitrectomized and filled with silicone oil between 1988 and 1992 were analysed. In 22 eyes (13.8%) silicone oil entered the anterior chamber postoperatively. Eyes with emulsified oil in the anterior chamber and eyes, where the oil entered the anterior chamber during cataract extr action were not included in this group. Diagnoses, postoperative fundu s findings and lens status, intraocular pressure, dephth of the anteri or chamber and time of the oil entrance were analysed. Results Risk fa ctors in the first 10 postoperative days (14 eyes = 63.6%) seem to be aphakia and choroidal effusions, especially if combined with buckling procedures (encircling bands). In the late postoperative period, i. e. up to 6.5 months (8 eyes = 36.4%), proliferative vitreoretinopathy wa s responsible for the entrance of silicone oil into the anterior chamb er in all cases. The decreased production of aqueous humour combined w ith hypotony seems also to play an important role in this process. Con clusions It seems that in the early postoperative period the frequency of oil entrance into the anterior chamber can only be lowered by a su btotal oil filling in aphakic eyes with accompanying encircling proced ures. It remains open if radical amputation of the vitreous base can a void peripheral reproliferations.