Silicone oil info

There have been several questions on both eye forums about SILICONE OIL. Because neither Dr. Kutryb no I are retinal surgeons I spoke with one of the retina surgeons in our group about recent questions.

1. Silicone oil can be left in the eye indefinitely although that isn't necessarily the recommended course. Typically most retinal specialists will try to remove oil after 4-6 months depending on how the retina looks. I have several patients that have a localized area of retinal that becomes detached under oil, for that reason I will elect to keep the oil in indifinitely due to the poor visual potential and the risk of redetachment if the oil is removed.

2. During removal it is always recommended to remove as much of the silicone oil as possible.

3. The biggest concerns with the silicone oil are corneal decompensation, migration into the anterior chamber, glaucoma and smulsification on the posterior surgace of a silicone intraocular implant (IOL).


JCH III MD

[John C Hagan III, MD, FACS, FAAO]

Please not the above information.

JCH III MD

[CatLady214]

What would cause a cut in the Iris at the pupil during a partial vitrectomy/pars plana lensectomy to remove a cataract and re reattach a retina?

[John C Hagan III, MD, FACS, FAAO]

It may have been done intentionally called a peripheral iridectomy. Often done with intraocular surgery to prevent the iris from blocking aqueious fluid from leaving the eye (a form of pupillary block - acute glaucoma).

JCH MD

[CatLady214]

No there was no glaucoma, in fact...I am suffering now from hypotony, and have no aqueous fluid being produced.  I am very worried about it.

[CatLady214]

Forgot to tell you I have silicone oil in too...I still can see out of this eye, not really well, but still can see with no lens and silicone oil.  

[berrywoo]

Dr. Hagan meant that the iridectomy is done to PREVENT glaucoma from occurring after silicone oil injection. Especially in those who are aphakic, the tendency for the silicone oil to cause a pupilary block is high, this would lead to an acute angle closure glaucoma attack and vision loss could be quick and irreversible.

[CatLady214]

There is nothing in my records to state that an iridectomy was performed. And from what I have seen of pics online, an iridectomy is a round excision in the iris, not a huge hunk out of the iris that makes the pupil look dilated and deformed.
I must have not been clear.  Sorry.

[CatLady214]

Hi,
Can the CILIARY BODY be seen either on a CT SCAN or with FLUORESCEIN ANGIOGRAPHY?

Would you be able to see whether it was actually there (or not), whether it was detached, injured or covered with scar tissue?

(considering no aqueous fluid is being produced...would the reason WHY be determined by either procedure?)

Or would surgery have to be performed to find out the reason?

Please let me know.  thanks so much.

[berrywoo]

yes, a ct scan and/or a FA would be used to determine problems with the ciliary body. It may not show exactly why there is something wrong, as with all other tests, but it would go a long way in ruling somethings out and thus help in making some sort of diagnosis.

[CatLady214]

thanks so much!