[Postoperative leakage of silicone oil into the anterior chamber]

One reason for complications after silicone oil application is the postoperative entrance of silicone oil into the anterior chamber. In a retrospective study, we tried to define risk factors for oil entrance into the anterior chamber.

159 Eyes of 148 patients, vitrectomized and filled with silicone oil between 1988 and 1992 were analysed. In 22 eyes (13.8%) silicone oil entered the anterior chamber postoperatively. Eyes with emulsified oil in the anterior chamber and eyes, where the oil entered the anterior chamber during cataract extraction were not included in this group. Diagnoses, postoperative fundus findings and lens status, intraocular pressure, depth of the anterior chamber and time of the oil entrance were analysed.

Risk factors in the first 10 postoperative days (14 eyes = 63.6%) seem to be aphakia and choroidal effusions, especially if combined with buckling procedures (encircling bands). In the late postoperative period, i.e. up to 6.5 months (8 eyes = 36.4%), proliferative vitreoretinopathy was responsible for the entrance of silicone oil into the anterior chamber in all cases. The decreased production of aqueous humour combined with hypotony seems also to play an important role in this process.

It seems that in the early postoperative period the frequency of oil entrance into the anterior chamber can only be lowered by a subtotal oil filling in aphakic eyes with accompanying encircling procedures. It remains open if radical amputation of the vitreous base can avoid peripheral reproliferations.