Silicone Oil Into the Suprachoroidal Space: An Illustrative Report and Literature Review

Silicone oil (SO) tamponade has been widely used in vitreoretinal surgery for complex retinal detachment cases, yet its migration into unintended intraocular spaces remains an uncommon but clinically significant complication. While sub-retinal and anterior chamber migration have been more frequently described, suprachoroidal SO migration is a rare event, with few reports in the literature. The underlying mechanisms proposed for this complication include transient hypotony, infusion cannula malposition, and structural vulnerabilities within the suprachoroidal space. This review synthesizes reported cases of suprachoroidal SO migration, detailing clinical presentations, surgical management approaches, and postoperative outcomes. Various drainage techniques have been attempted, including transscleral evacuation through posterior sclerotomies, internal drainage into the vitreous cavity via pars plana incisions, and adjunctive perfluorocarbon liquid injection to facilitate oil displacement. While some cases have been managed conservatively without surgical intervention, the long-term implications of retained SO in the suprachoroidal space remain largely unknown. Given its potential association with ciliary detachment, hypotony, and visual disturbances, careful patient monitoring is warranted. The current literature lacks comprehensive studies on the biological behavior of SO within the suprachoroidal compartment, and further investigations are necessary to assess its stability, potential toxic effects, and indications for surgical removal. This review aims to provide vitreoretinal surgeons with a systematic understanding of suprachoroidal SO migration, offering insights into pathophysiology, prevention strategies, and optimal surgical management based on current evidence.