OSLI Retina

May 2020

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May 2020 · Vol. 51, No. 5 307 ■ C L I N I C A L S C I E N C E ■ Adherence of Intravitreal Silicone Oil Bubbles to a Silicone Intraocular Lens Saumya M. Shah, MD; Sophie J. Bakri, MD ABSTRACT: The authors present a case of diffuse silicone oil deposits from intravitreal anti-vascular endothelial growth factor injections adhering to the posterior capsule of a silicone intraocular lens. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:307.] A 78-year-old male underwent uncomplicated phacoemulsification with a silicone intraocular lens (IOL) implantation in his right eye 7 years ago. He presented with blurry vision 1 month after cataract surgery and was diagnosed with exudative age-relat- ed macular degeneration (AMD) in his right eye. The patient received 30 intravitreal bevacizumab (Avas- tin; Genentech, South San Francisco, CA) injections in the right eye over the next 6 years at a 4- to 12-week interval to manage the exudative AMD. He was sub- sequently found to have diffuse silicone oil deposits adhering to the posterior capsule silicone IOL in his right eye (Figures 1A and 1B). Given that he had no prior vitreoretinal surgeries utilizing silicone oil, 1,2 the phenomenon was attributed to the silicone oil coating in the syringe. 3-6 A clear view of adherence of small silicone oil droplets to a silicone IOL after in- travitreal injections has been previously undescribed. The patient continues to remain visually asymptom- atic despite the silicone oil deposits and receives in- jections for exudative AMD. REFERENCES 1. Kusaka S, Kodama T, Ohashi Y. Condensation of silicone oil on the posterior surface of a silicone intraocular lens during vitrectomy. Am J Ophthalmol. 1996;121(5):574-575. https://doi.org/10.1016/S0002- 9394(14)75436-4 PMID:8610805 2. Apple DJ, Federman JL, Krolicki TJ, et al. Irreversible silicone oil ad- hesion to silicone intraocular lenses. A clinicopathologic analysis. Oph- thalmology. 1996;103(10):1555-1561. https://doi.org/10.1016/S0161- 6420(96)30463-6 PMID:8874426 3. Freund KB, Laud K, Eandi CM, Spaide RF. Silicone oil droplets fol- lowing intravitreal injection. Retina. 2006;26(6):701-703. https://doi. org/10.1097/01.iae.0000223177.08438.2b PMID:16829818 4. Scott IU, Oden NL, VanVeldhuisen PC, Ip MS, Blodi BA, Antoszyk AN; SCORE Study Investigator Group. SCORE Study Report 7: incidence of intravitreal silicone oil droplets associated with staked-on vs luer cone syringe design. Am J Ophthalmol. 2009;148(5):725-732.e7. https://doi. org/10.1016/j.ajo.2009.06.004 PMID:19674727 5. Bakri SJ, Ekdawi NS. Intravitreal silicone oil droplets after intravitreal drug injections. Retina. 2008;28(7):996-1001. https://doi.org/10.1097/ IAE.0b013e31816c6868 PMID:18698303 6. Khurana RN, Chang LK, Porco TC. Incidence of Presumed Silicone Oil Droplets in the Vitreous Cavity After Intravitreal Bevacizumab Injec- tion With Insulin Syringes. JAMA Ophthalmol. 2017;135(7):800-803. https://doi.org/10.1001/jamaophthalmol.2017.1815 PMID:28617905 From Mayo Clinic, Department of Ophthalmology, Rochester, Minnesota. Originally submitted January 30, 2020. Revision received January 30, 2020. Accepted for publication March 30, 2020. Dr. Bakri has received personal fees from Allergan, Alimera, Genentech, Novartis, Roche, Oxurion, and Eyepoint outside the submitted work. Dr. Shah reports no relevant financial disclosures. Address correspondence to Sophie J. Bakri, MD, Mayo Clinic, Department of Ophthalmology, 200 First Street SW, Rochester, MN 55905; email: bakri. sophie@mayo.edu. doi: 10.3928/23258160-20200501-10 Figure 1. Slit-lamp examination of the anterior chamber of the right eye showing diffused silicone oil bubbles (A) adhering to the posterior capsule silicone intraocular lens (B).

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