Abstract
Silicone oil is increasingly used as an intravitreal tamponade in severe forms of vitreoretinal disorders, also in pseudophakic eyes. In some patients silicone oil was observed to be adherent to the intraocular implant. To investigate the interaction of silicone oil with IOL-materials and the influence of lipoproteins of the serum on this interaction we used the following in vitro experimental set-up: Sterile IOLs of different IOL-materials (e.g. PMMA, silicone, hydrogel) and surface-modifications (e.g. Pharmacia 809P and 809C, Soflex LI41U, Alcon AcrySof M60BM, Allergan SI-30NB, SI-40NB, Chiron adatomed 90D, C10 and C31UB, MemoryLens U940A, Corneal ISHEMA 66, Storz H60M) were stored in vitro together with silicone oil (1000 centistokes) with and without a fresh serum solution at 37 degrees Celsius. This combination was rotated slowly and mixed thoroughly three times a day. After 3 and 6 months and a standardized special preparation in an ultrasound bath and air treatment, the IOLs were examined by light microscopy followed by scanning electron microscopy. Silicone oil strongly adhered to holes and to the IOL surface especially in silicone and PMMA IOLs. Highly hydrophylic IOLs-like the heparin-surface-modified and hydrogel IOL-cleared from silicone oil relatively early. This effect was more pronounced in the group with lipid-/serum solution than without. In some silicone IOLs silicone oil was strongly adherent to the lens and it was nearly impossible to wash off the oil even when using an alcoholic solution. One silicone IOL lost its haptics in the serum-oil-IOL-mixture, another lost small particles from the IOL surface. Silicone oil is more adherent to hydrophobic IOLs than to hydrophylic IOLs. Lipoproteins of the serum play an important role in facilitating an effect of silicone oil on IOL materials. We recommend highly hydrophylic especially surface-modified IOLs for lens implantation following vitreoretinal silicone oil surgery. Implantation of silicone IOLs in vitreoretinal high risk eyes should be avoided.
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