Cataract With Intraocular Silicone Oil
In an eye with silicone oil, the cataract usually is very soft. It is important to avoid pressurizing the eye with excessive OVDs or a high infusion pressure of balanced salt solution. During cataract surgery, silicone oil can migrate through a break in the zonular fibers if the AC is overfilled with OVDs. This can be counteracted with the use of low-flow irrigation or decreased aspiration rate during surgery. Droplets of silicone oil that were not apparent in the AC during surgery might become visible postoperatively. A few droplets are usually not toxic to the cornea. Silicone lens implants are contraindicated in these eyes because silicone oil adheres to the implant surface. The surgeon can create an inferior iridotomy if a patent one is not already present. (See Chapter 7 for a discussion of IOL calculations in eyes with silicone oil.)
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.