The effect of silicone ocular surgical devices on serum IgE binding to silicones

PURPOSE: To determine whether silicone materials used in retinal detachment repair and cataract surgery increase serum IgG binding to silicone and ide ntify correlations with complications of ocular surgery. METHODS: Serum from 49 patients who had ocular surgery using silicone mater ials was examined. Patient groups included scleral buckling (n = 25), silic one oil tamponade (n = 3), scleral buckling and silicone oil tamponade (n = 9), and silicone lens implants after cataract extraction (n = 12), Convale scent samples for all patients and preoperative samples from 19 patients (1 8 scleral buckling and one silicone oil tamponade) were examined. Postopera tive complications were monitored for up to 108 months (mean, 10.7 months; mode, 1,5 months; range, 1 to 108 months). Samples were evaluated for the e xtent of IgG binding to silicones using a micromodification of a previously described enzyme-linked immunosorbent assay method, RESULTS: In 19 patients, IgG binding levels in preoperative samples were 21 arbitrary units (AU) or less. Of the 25 buckling patients, one developed c omplications; however, in all patients the postoperative levels of IgG bind ing to silicone were low (2.2 to 20.0 AU). Although four silicone lens pati ents developed mild complications, none displayed postoperative IgG binding levels of greater than 20 AU, Three patients who underwent both scleral bu ckling and silicone oil tamponade developed complications; one of these pat ients, who was also noted to have systemic connective tissue disease, had a significant elevation in postoperative serum IgG binding to silicone. CONCLUSIONS: Statistically significant eleva tions of serum IgG binding to silicone were noted postoperatively in only one patient who had a systemic connective tissue disease. The complication rare and frequency of enhanced serum IgG binding to silicone was low, making correlations to surgical comp lications difficult Examination of matched samples suggested that if ocular exposure to silicone implants enhances the level of serum IgG binding to s ilicones, it: must be a rare event that should not alter the clinical use o f these important devices. (Am J Ophthalmol 1998;126: 198-804. (C) 1998 by Elsevier Science Inc. All rights reserved.).