Purpose: The purpose was to study the emulsification of silicone oil tamponade agents that cause clinical complications. This study aimed to increase the emulsification resistance of silicone oil 1,000 to be at least as resistant as silicone oil 5,000 while maintaining the shear viscosity <5,000 mPa/s to aid injection and removal.

Methods: High-molecular-weight (423 kDa) poly(dimethyl siloxane) was added to silicone oil 1,000 at 5% and 10% w/w concentration. The shear and extensional viscosity of 1,000 and 5,000, a 50:50 mixture of 1,000 and 5,000 and 5% and 10% w/w additive blends, respectively, of silicone oil were measured using capillary breakup extensional, rotational shear, and capillary extrusion rheometry. In vitro emulsification was assessed qualitatively after agitation using Pluronic F68 or a protein solution as the emulsion stabilizer.

Results: The addition of high-molecular-weight polymer increased the extensional viscosity of the blends at high strain rates to levels equal to or greater than silicone oil 5,000. In all cases, the shear viscosity of the blends was lower than that of silicone oil 5,000. The additive blends were qualitatively as emulsification-resistant as silicone oil 5,000.

Conclusion: The addition of low concentrations of very-high-molecular-weight polymers of the same chemistry as the bulk oil has the potential to increase the emulsification resistance of the tamponade agents while maintaining ease of injection and removal.

Increasing the extensional viscosity of silicone oil reduces the tendency for emulsification.

Silicone oil represents the main choice for intraocular tamponade in cases of complicated retinal detachment surgery. The intraocular pressure of an eye filled with silicone oil could increase, driven by a variety of different forces, according to several mechanisms. Two main conditions have been highlighted, depending on the onset: early hypertension or late glaucoma. The different types of silicone oils and their physico-chemical properties are varied and may play a role in the determination of intraocular pressure rise. The current body of literature allows for the illustration and categorization of the incidence and risk factors, as well as the pathogenesis and the management of the early postoperative hypertension subtended by an open- and closed-angle, along with the late onset silicone oil-induced glaucoma. Understanding the leading actors on the stage of ocular pressure elevation concurrently with silicone oil application for retinal surgery could help in guiding the timely and appropriate course of treatment.

Intraocular Pressure Rise Linked to Silicone Oil in Retinal Surgery: A Review

Resume L’huile de silicone est un moyen de tamponnement efficace utilise dans le traitement des decollements de retine severes. Un suivi attentif des patients est necessaire du fait des complications associees a son utilisation. Celles-ci peuvent etre precoces comme l’augmentation transitoire de la pression intraoculaire ou la survenue d’une inflammation de segment anterieur en postoperatoire immediat. Elles peuvent etre tardives a type de cataracte, d’emulsification, de modifications pressionnelles, de keratopathie ou de recidive du decollement retinien suite a une proliferation vitreoretinienne.

Surveillance d’un tamponnement par huile de silicone

Background
Intraocular silicone oil (SiO) impurities as low molecular weight components (LMWC) and residual catalysts are thought to cause ocular toxicity. A case-control study was initiated to determine if highly purified SiOs of equal viscosity from two different manufacturers had a similar chemical stability after prolonged clinical use as a vitreous substitute in patients.

Chemical impurities and contaminants in different silicone oils in human eyes before and after prolonged use

Background: Oxane HD is a mixture of 5700 cs silicone oil and RMN-3 (a partly fluorinated olefin), which has a specific gravity greater than water, thereby enabling endotamponade of inferior retinal breaks. Droplets of emulsified oil were found in the anterior chamber of two patients with complex retinal detachments who had been treated with Oxane HD. Samples removed from these two eyes were analysed in order to investigate the nature of the emulsified substance. Methods: Samples were dissolved in CDCl3 and, if necessary, dried using magnesium sulphate. Nuclear magnetic resonance (NMR) was used to compare these samples with the unused commercial product. Results: NMR analysis of the samples removed from the anterior segment of both eyes were mainly silicone oil with only trace amounts of RMN-3. Samples taken from different areas of an unused syringe of Oxane HD demonstrated varying concentrations of the RMN-3 compound within the silicone oil. Conclusion: First, the mixture of RMN-3 and silicone oil is not homogenous either in vitro or in vivo . Second, emulsified oil found in the anterior chamber is composed almost entirely of silicone oil, containing only trace amounts of RMN-3.

/pdf/nuclear-magnetic-resonance-analysis-of-emulsified-silicone-1ng4s5wpvy.pdf

Nuclear Magnetic Resonance Analysis of Emulsified Silicone-Oil RMN-3 (Oxane HD)

Purpose: To investigate whether structural changes occur in silicone oil that has been left in the eye for different periods and to research the relationship of emulsification with the time during which silicone oil is left in the eye, glaucoma, and wide relaxing retinotomy.

Methods: Samples of silicone oil were randomly removed from the eyes of 22 patients. Gel permeation chromatography (GPC) and spectroscopy were used to identify any changes in the silicone oil. The relationship between spectroscopically determined emulsification with time spent in the eye, glaucoma, and wide relaxing retinotomy was investigated statistically.

Results: GPC revealed that no change was found in the 1,000-centistoke silicone oil model after it had been removed from the eye. Spectroscopy identified absorption peaks belonging to water in addition to those belonging to the functional groups. The relationships between emulsification and time spent in the eye and glaucoma were found to be statistically insignificant, while that between emulsification and wide relaxing retinotomy was statistically significant.

Conclusion: Intravitreally applied silicone oil undergoes no structural change. Wide relaxing retinotomy constitutes a risk factor for silicone oil emulsification, which can occur earlier than expected and before it can be observed clinically.

Fourier transform infrared and 1h nuclear magnetic resonance spectroscopic findings of silicone oil removed from eyes and the relationship of emulsification with retinotomy and glaucoma.

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Fourier transform infrared and 1h nuclear magnetic resonance spectroscopic findings of silicone oil removed from eyes and the relationship of emulsification with retinotomy and glaucoma.