[Silicone oil in surgery of complicated retinal detachment]

Silicone oil has established itself as an internal tamponade in the treatment of complicated retinal detachments. The most common indications are PVR, advanced proliferative diabetic retinopathy, giant tears and severe trauma to the posterior segment of the eye. Other rarer indications have meanwhile been added. By its use success rates can be achieved that were thought impossible only ten years ago. Serious complications such as secondary glaucoma and keratopathy, much dreaded in the early years of its use, are better understood and are generally not considered contraindications anymore. Secondary glaucoma occurs in about 20% of eyes, has a wide variety of causes and is rarely attributable to the silicone oil itself, provided purified and highly viscous oil is used. The development of keratopathies has been greatly reduced by the introduction of the Andoiridectomy and this complication is now largely confined to eyes with severe trauma, hypotony or aniridia. Toxic effects of silicone oil have so far not been convincingly demonstrated. Whereas similar results can be obtained by the use of long-acting intraocular gases in milder cases of the conditions described, silicone oil tamponade has proved to be an effective treatment in the more advanced forms of complicated retinal detachments.