Effect of silicone oil on the cornea

Silicone oil can dissolve about seven times more oxygen that can water. Placed in a depot between a rigid scleral lens and the corneal surface, silicone oil might thus be useful for treating severe dry-eye patients and for preventing exposure keratitis. To explore this possibility, generic (300, 500, 1000, and 12,500 cs) and medical-grade (1000 cs) silicone oils were tested on rabbit eyes. When oxygenated silicone oil was placed in a cup formed by the lids and hanging sutures and allowed to remain for 3 h on the eyes of anesthetized rabbits, the immediate reaction was mild epithelial edema. By 3 to 6 days later, the thickness of the epithelium and of the entire cornea had increased irregularly. The most common histologic finding was intracellular epithelial edema, particularly in the basal cell layer. The reaction was most intense for the generic oils of the lowest viscosities. The medical-grade oil was the best tolerated, but it too affected epithelial and corneal thickness. Ultrastructural studies of treated eyes showed abnormal epithelial surfaces but no major changes within the epithelial cells. Biochemical analysis showed some decrease of glycogen in the corneal epithelium of eyes kept under oxygenated medical-grade silicone oil. A smaller decrease of glycogen level persisted after 2 days exposure of the treated eye to air, suggesting that the corneal epithelium was injured by a mechanism other than hypoxia.