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Subconjunctival silicone oil complicating strabismus surgery
Shailja Tibrewal1, Rolli Khurana1, Ramesh Venkatesh2
1Paediatric Ophthalmology and Strabismus Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India.
GMS Ophthalmology Cases
|June 4, 2019
Summary
Subconjunctival silicone oil from prior eye surgeries complicated a routine strabismus repair, causing inflammation and surgical difficulty. Prompt removal of silicone oil nodules resolved the issue, restoring ocular comfort and alignment.
Area of Science:
- Ophthalmology
- Retina Surgery
- Strabismus Surgery
Background:
- Silicone oil is used as an endotamponade in vitreoretinal surgery.
- Complications from silicone oil, while known, are typically intraocular.
- Subconjunctival silicone oil accumulation is an uncommon but significant finding.
Observation:
- A 15-year-old male presented for strabismus surgery (sensory exotropia).
- The patient had a history of two vitreoretinal surgeries, the latter involving silicone oil injection.
- Extensive subconjunctival silicone oil nodules were discovered during the strabismus procedure, causing episcleral fibrosis.
Findings:
- Surgical intervention required removal of silicone oil cysts and tenon's fascia.
- Extraocular muscles were managed using an adjustable suture technique.
- The strabismus was successfully corrected, and ocular symptoms resolved postoperatively.
Implications:
- Subconjunctival silicone oil can cause significant inflammation and complicate strabismus surgery.
- Careful preoperative assessment is crucial in patients with a history of silicone oil use.
- Management strategies may need to be adapted for strabismus surgery in the presence of subconjunctival silicone oil.
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