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PubMed2001

Effect of heparin surface modification in reducing silicone oil adherence to various intraocular lenses.

PURPOSE: To evaluate surface properties of various intraocular lenses (IOLs), including a newly fabricated heparin-surface-modified (HSM) silicone IOL, with special reference to their efficiency in reducing potential silicone oil adherence to the IOL optics. SETTING: Center for Research on Ocular Therapeutics and Biodevices, Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: Five groups of rigid and foldable IOLs were analyzed in an in vitro test for the percentage of silicone oil adherence: a single-piece foldable hydrophilic-acrylic IOL (n = 9); a single-piece rigid poly(methyl methacrylate) (PMMA) IOL with HSM coating of the lens optic (n = 9); a 3-piece foldable silicone optic IOL with HSM coating of the optic (n = 10); a single-piece standard rigid PMMA IOL (n = 7); and a standard 3-piece foldable silicone optic IOL (n = 9). After the IOLs were immersed in water and then in silicone oil, gross photographs taken. Image analysis was performed to evaluate the percentage of silicone oil coverage of the anterior and posterior surfaces of each IOL optic. RESULTS: The mean silicone oil coverage of the hydrophilic-acrylic IOLs was 5.6% +/- 2.5% (SD); of the HSM PMMA IOLs, 6.2% +/- 4.3%; of the HSM silicone optic IOLs, 6.7% +/- 3.2%; and of the standard PMMA IOLs, 20.3% +/- 13.3%. The mean silicone oil coverage was greatest on the standard silicone optic IOLs, 98.2% +/- 3.1%. CONCLUSIONS: Intraocular lenses with a hydrophilic optic have less tendency toward adherence to silicone oil than more hydrophobic designs. A foldable silicone IOL with heparin surface modification can significantly reduce potential silicone oil adherence, comparable to the level achievable with the rigid HSM PMMA designs. Two new foldable IOL styles, the HSM silicone IOL and IOLs in the general class of hydrophilic-acrylic, were highly efficacious in reducing silicone oil adherence. There is now a real choice of foldable lenses for patients with actual or potential vitreoretinal diseases.

Acrylic Resins↗
PubMed1994

Histopathology of rabbit eyes with intravitreous silicone-fluorosilicone copolymer oil.

Silicone-fluorosilicone copolymer oil is characterized by being heavier than water (density, 1.16 g cm-3) and low viscosity (175-185 centistokes) compared with currently used intraocular silicone oils (density, 0.97 g cm-3 and 1000-5000 centistokes). This oil is potentially useful as an operative tool and a tamponade on the inferior retina in complicated retinal detachment. We evaluate the ocular response clinically and histopathologically within 8 weeks in rabbit phakic eyes to the purified silicone-fluorosilicone copolymer oil after vitreous cavity injection, and compared the oil tolerance with purified silicone oil (0.97 g cm-3, 5000 centistokes) and perfluorotetradecahydrophenanthrene for ophthalmic use (Vitreon, 2.03 g cm-3, 8.03 centistokes) which are currently used as operative tools and as internal retinal tamponade agents in retinal detachment surgery. Because of their low viscosity, silicone-fluorosilicone copolymer oil and perfluorotetradecahydrophenanthrene were easier to inject into the eye than silicone oil. Silicone-fluorosilicone copolymer oil and perfluorotetradecahydrophenanthrene occupied the inferior portion in the eye, and silicone oil occupied the superior portion. Fewer discrete oil droplets and weaker vessel attenuation of medullary rays than in the perfluorotetradecahydrophenanthrene-injected eyes were seen in silicone-fluorosilicone-copolymer-oil-injected eyes. Histopathologically, all retinas injected with silicone-fluorosilicone copolymer oil were normal within 4 weeks. The silicone-fluorosilicone copolymer oil dispersion did not induce histopathological changes within 8 weeks. However, thinning or disappearance of the outer plexiform layer was seen in the inferior retina in some silicone-fluorosilicone-copolymer-oil-injected eyes at 6-8 weeks. A similar effect was found in the superior retina of a silicone-oil-injected eye at 8 weeks. More severe changes such as thinning or disappearance of the outerplexiform layer, thinning and disorganization of the photoreceptor layer, and migration of the receptor cell nuclei to the photoreceptor layer were found in the inferior retina of perfluorotetradecahydrophenanthrene-injected eyes after 2 weeks. Intraocular silicone-fluorosilicone copolymer oil tolerance until about 2 months post-injection is similar to silicone oil and better than perfluorotetradecahydrophenanthrene. Silicone-fluorosilicone copolymer oil may be useful intraoperatively and as a temporary vitreous substitute in cases of inferior retinal detachment.

Animals↗
PubMed1996

Does the human cornea contain silicon?

BACKGROUND: Our study investigated the presence, type and quantity of silicon in the human cornea. We report the results of silicon measurements in the corneas of silicotic individuals, bricklayers and apparently normal human individuals and offer a hypothesis for the mechanism of silicon deposition in the human cornea. METHODS: We examined corneas from 13 decreased subjects who suffered from silicosis, 2 bricklayers and 6 apparently healthy subjects. Cornea samples were examined by energy-dispersive x-ray analysis (EDXA) under calibrated conditions in a scanning electron microscope (SEM). The EDXA detector was a silicon-free germanium crystal. Five distinct layers (epithelium, Bowman's membrane, central stroma. Descemet's membrane and endothelium) were analyzed in each cornea. The method allows simultaneous semiquantitative analysis of, among other elements, silicon, calcium and oxygen. We measured amorphous silicon and visible particles of silicon. RESULTS: We found amorphous silicon in low concentrations in 38% of the silicotic corneas and in very low concentrations in 29% of the healthy corneas. Bricklayers showed high concentrations of amorphous silicon. These accumulations of silicon were predominantly located in Descemet's membrane. Silicotic corneas showed significantly more silicon-containing particles than corneas of healthy controls (chi 2-test, P < 0.01). CONCLUSION: Normal corneas contain very low amounts of silicon. Longterm exposure to inhalative silicon dusts results in only very slightly increased levels of amorphous silicon in the cornea. However, silicon-containing particles accumulate in the cornea of silicotic individuals. Bricklayers incorporate more amorphous silicon into the cornea.

Aged↗
PubMed1999

[O44--a solvent for silicone oil adhesions on intraocular lenses].

AIM: To examine the efficiency of O44, a partial fluorinated octane, as a solvent for silicone oil adhesions on intraocular lenses. MATERIALS AND METHODS: After placing silicone- and PMMA-lenses in silicone oil, the adhesions were treated with O44. The extent of silicone oil adhesions and the effectiveness of O44 were studied by gross microscopy by scanning electrone microscopy (SEM) and combined energy dispersive spectrometry (EDX). Furthermore an explanted silicone lens with oil adhesions was treated with O44 and examined. To simulate the effect of adhesion proteins PMMA- and silicone lenses were placed in silicone oil and human plasma. RESULTS: With EDX it was possible to prove that O44 is able to remove silicone oil adhesions from PMMA-lenses. The removal from an explanted silicone lens by O44 could be demonstrated by light microscopy. Silicone oil adhesions on intraocular lenses (IOL's) in vitro showed a different oil coverage than the IOL in vivo. Silicone lenses in vitro were often covered by a homogenous oil film and therefore the demonstration of the silicone adhesions and of the efficacy of O44 was difficult. The adhesions of IOL's placed additional in human plasma did not show any differences. CONCLUSIONS: O44 may be a successful intraoperative tool to remove silicone oil adhesions avoiding explantation of silicone oil contaminated IOL's. Silicone oil adhesions in vivo seem to be influenced by adhesive proteins.

Efficiency↗
PubMed1997

[Interaction of silicone oil with various intraocular lenses. A light and scanning electron microscopy study].

BACKGROUND: 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. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Equipment Failure Analysis↗
PubMedDate not supplied

Silicone-suppressed 3D MRI of the breast using rotating delivery of off-resonance excitation.

OBJECTIVE: A new silicone-suppressed MR technique was developed, and its efficacy in identifying free silicone and differentiating it from other breast tissues was investigated. MATERIALS AND METHODS: Silicone-suppressed MRI was performed using the RODEO (rotating delivery of excitation off-resonance) pulse sequence, which selectively eliminated signal from the narrow range of (CH3)4Si resonance. Ninety breasts in 61 patients were evaluated with both a fat-suppressed 3D MR sequence and a silicone-suppressed 3D MR sequence. RESULTS: Extracapsular free silicone and silicone injections demonstrated a unique appearance compared with normal breast tissue in all cases. Magnetic resonance identified free silicone in 26 breasts, 10 of which were confirmed pathologically or from a history of previous silicone injections. No free silicone was present on MR in 64 breasts; 8 of these were confirmed by biopsy or mastectomy as showing no evidence of free silicone. This technique was useful in evaluation of prosthesis integrity, free silicone, focal palpable or mammographic lesions, and the breast with silicone injections. CONCLUSION: Silicone-suppressed RODEO MRI of the breast can accurately identify free and intracapsular silicone and can distinguish silicone from other tissues. This provides unique information about the breast in a number of specific applications.

Adult↗
PubMed1997

Silicon tissue assay: a measurement of capsular levels from chemotherapeutic port-a-catheter devices.

A plethora of data has been used to condemn and defend the role of silicone and its association with "adjuvant disease." In the ongoing attempt to enhance our knowledge, we have chosen to identify tissue silicon levels (n = 15) in capsules that form around chemotherapeutic port-a-catheter devices, which consist of a metal dome encapsuled by silicone. We have compared these levels with previously established silicon levels in augmented breast capsules, distant tissue sites in these same augmented women, and nonaugmented cadaveric tissues from various geographic locations in the United States. All specimens were harvested by a "no touch" technique, not formalin fixed, frozen, and shipped to an independent toxicology laboratory for analysis. Inductively coupled plasma atomic emission spectroscopy was employed to obtain the tissue silicon measurements. Results demonstrated silicon values ranging from nondetectable in 9 patients to as high as 41 micrograms/gm. These values fell in between our cadaveric (0.5 to 6.8 micrograms/gm) and augmented tissue silicon levels (18 to 8700 micrograms/gm). Although the sample size is small and the power of statistical analysis is low, there was no correlation between the patient's silicon level and age, type of cancer, type of chemotherapeutic agent, radiation therapy, or length of time the port-a-catheters were in place. Although detectable levels of silicon identified around port-a-catheter devices were higher than expected, it is impossible to make any conclusions about these levels and the role of a potential collagen-vascular disease. What we have shown, however, is that silicone breast implants may not be the only medical device that can elevate tissue silicon levels. Our data seem to suggest that there may be a progression of measurable tissue silicon levels based on the amount of environmental or device-related silicon exposure a person has had at a particular time in his or her life. It is our belief that as we identify these tissue silicon levels, they will serve as a baseline and reference for further scientific studies.

Adolescent↗
PubMed1999

Influence of long term silicone implantation on type II collagen induced arthritis in mice.

OBJECTIVES: The use of silicone implants in cosmetic and reconstructive surgery has been implicated in the development of autoimmune connective tissue diseases. Previous investigation of the influence of short-term silicone implantation using an experimental model of rheumatoid arthritis revealed no adverse influence upon disease despite the generation of autoantibodies against silicone bound proteins. This study was designed to examine the influence of long term implantation of different forms of silicone in collagen induced arthritis. METHODS: DBA/1 mice were surgically implanted with silicone elastomers, gel or oil nine months before immunisation with type II collagen emulsified in Freund's incomplete adjuvant. The incidence and severity of arthritis, antibodies to type II collagen, and serum cytokines were assessed and compared with sham implanted mice. Silicone implants were recovered, and autoantibodies to silicone bound proteins evaluated in arthritic and non-arthritic mice. RESULTS: Immunisation with CII/FIA resulted in a 30% arthritis incidence in sham implanted DBA/1 mice. Long term silicone implantation resulted in an increased incidence of arthritis, with a significant increase of 90% arthritis in animals implanted with silicone elastomers. Animals implanted with silicone elastomer also developed foreign body sarcomas during the study. Serum concentrations of interleukin 10 were increased in mice implanted with elastomers and immunised with CII/FIA, while interleukin 5 concentrations were significantly diminished in these mice. The production of autoantibodies to autologous silicone bound proteins, including anti-type I collagen antibody, was also attributed to the implantation of either silicone gel or silicone elastomer in type II collagen immunised animals. CONCLUSIONS: These data suggest that long term silicone implantation results in both the production of autoantibodies to connective tissue antigens and increased susceptibility to an experimental model of autoimmune disease.

Animals↗
PubMed1994

High dietary aluminum affects the response of rats to silicon deprivation.

Antagonistic interactions between silicon and aluminum occur in living organisms. Thus, an experiment was performed to ascertain whether high dietary aluminum would accentuate the signs of silicon deprivation in rats and conversely whether silicon deprivation would accentuate the response to high dietary aluminum. The experiment was factorially arranged with two variables: silicon as sodium metasilicate, 0 or 40 micrograms/g diet, and aluminum as aluminum citrate, 0 or 500 micrograms/g diet. After 9 wk, body weights and plasma urea nitrogen were higher and plasma concentrations of threonine, serine, glycine, cystine, and methionine were lower in silicon-adequate than silicon-deprived rats. High dietary aluminum significantly decreased plasma phenylalanine. An interaction between aluminum and silicon affected plasma triglyceride, cholesterol, and phosphorus concentrations. High dietary aluminum decreased these variables when silicon was absent from the diet, but increased them when silicon was present. Skull iron and silicon concentrations were decreased and iron and zinc concentrations in the femur were increased by the addition of 500 micrograms Al/g diet. High dietary aluminum decreased tibia density in silicon-adequate rats, but increased tibial density in silicon-deprived rats. The findings indicate that in rats, high dietary aluminum can affect the response to silicon deprivation and dietary silicon can affect the response to high dietary aluminum.

Aluminum↗
PubMed2004

Biomimetic growth of apatite on hydrogen-implanted silicon.

Hydrogen in silicon has been widely applied in semiconductor fields. In this paper, the application of hydrogen-implanted silicon wafer in biomedical fields was explored by investigating its bioactivity. Hydrogen implanted silicon wafers were prepared using plasma immersion ion implantation. The surface structures of the 1.4 x 10(17) cm(-2) hydrogen-implanted silicon wafers were investigated using atomic force microscopy and transmission electron microscopy (TEM). The hydrogen depth profiles were acquired by SIMS and the crystal quality of the as-implanted silicon was studied by channeling Rutherford backscattering spectrometry (RBS). The bioactivity of the implanted silicon was evaluated using the biomimetic growth of apatite on its surface after it was soaked in simulated body fluid for a period of time. The TEM, SIMS and RBS results indicate the formation of an amorphous hydrogenated silicon (a-Si:Hx) layer has been formed on the surface of the hydrogen-implanted silicon wafer. After immersion in SBF for 14 days, bone-like apatite is observed to nucleate and grow on the surface. With longer soaking time, more apatite appeared on the surface of the hydrogen implanted silicon but our control experiments did not reveal any apatite formation on the surface of the un-implanted silicon wafer, hydrogenated crystalline silicon wafer (with hydrogen, but no amorphous surface), or argon-implanted silicon wafer (amorphous surface but without hydrogen). Our results indicated that the bioactivity of silicon wafer can be improved after hydrogen implantation and the formation of the amorphous hydrogenated silicon (a-Si:Hx) surface also plays a synergistic role to improve the bioactivity.

Alpha Particles↗
PubMed2005

[Results of treating rhegmatogenous retinal detachment with vitrectomy and silicone oil tamponade].

INTRODUCTION: Silicone oil is used in the treatment of rhegmatogenous retinal detachment when there is a high risk of postoperative proliferative vitreoretinopathy (PVR). This type of internal tamponade can be responsible for serious side effects. Removal of silicone oil is necessary to ensure a long-lasting functional result. The purpose of this study was to evaluate the results of using a transient internal tamponade with silicone oil. PATIENTS AND METHODS: A retrospective review of cases of rhegmatogenous retinal detachment treated with internal tamponade with silicone oil for the first time in a 1-year period (January 2001 to December 2001) was conducted. We studied the type of retinal detachment, treatment before vitrectomy and silicone oil tamponade, indication for silicone oil tamponade, surgical steps and their results, causes of recurrent retinal detachment, and final visual acuity. Anatomical success was defined as a reattached retina after silicone oil removal. RESULTS: Ninety-three patients were included. Anatomical success was achieved, after one or several procedures, in 71 patients (76.3%). The mean total number of surgical procedures was 2.6. After initial surgery, recurrence of retinal detachment after removal of silicone oil occurred in 17.0% of the cases. Recurrence of retinal detachment under silicone oil occurred in 45.1% of the cases; the cause of the recurrence was PVR in 97.6% of those patients. No serious complication of silicone oil tamponade occurred. The mean duration of the tamponade was 6.7 months. The best results were achieved among patients showing no recurrence with silicone oil: visual acuity above 4/200 in 84.6% of the patients, above 20/200 in 61.5% of the patients and above 80/200 in 20.5% of the patients. In case of recurrence with silicone oil treatment, visual acuity reached 4/200 in 70.4% of the patients and was above 20/200 in 25.9% of the patients. DISCUSSION AND CONCLUSION: The results of this study are equivalent to those of studies in which analysis was made after removal of silicone oil. Proliferative vitreoretinopathy remains the only risk factor of retinal detachment recurrence with silicone oil (p<0.01). The number of previous surgeries is not a risk factor for postoperative PVR. Retinectomy is a surgical procedure that seems to improve the results in cases of severe PVR.

Adult↗
PubMed1999

Acute corneal decompensation after silicone oil removal.

PURPOSE: To assess acute corneal decompensation after silicone oil removal in some aphakic eyes with clear corneas whose anterior chambers were completely filled with silicone oil for a considerable period of time. METHODS: Eight eyes of 8 patients who underwent vitrectomy and intraocular silicone oil injection were studied. All the eyes were aphakic and anterior chambers were completely filled with silicone oil. In all eyes, corneas were clear and no corneal finding indicating keratopathy was detected by slit-lamp microscopy before silicone oil removal. The mean silicone oil removal time was 4 months (range 2-7 months). A specular microscope was used for the evaluation of corneal endothelial changes and corneal pachometry was performed to observe corneal changes before and after the silicone oil removal in 5 eyes besides slit-lamp microscopy. The follow up period after silicone oil removal was 2-12 months (mean 6 months). RESULTS: In all eyes severe corneal stromal edema and clouding was detected in the first day following silicone oil removal. Increased corneal thickness was seen in all eyes. Decreased (at or below critical levels) corneal cell density was detected by specular microscopy before and after silicone oil removal. No significant improvement was observed during the follow up period. CONCLUSION: Eyes whose anterior chambers completely filled with silicone oil could be evaluated as clear corneas by slit lamp microscopy despite severe endothelial damage. We recommend that eyes with silicone oil in the anterior chambers should be monitored by a combination of slit-lamp microscopic examination and specular microscopy to determine the relative corneal endothelial tolerance to the silicone oil and endothelial damage. Early removal of the silicone oil can be considered when the retinal adhesion allows.

Acute Disease↗
PubMed2002

Shur-clens: an agent to remove silicone gel after breast implant rupture.

Removal of silicone gel from surrounding tissues after implant rupture is difficult. Local inflammation, infection, and silicone granulomas warrant thorough removal of the silicone gel. Shur-Clens (20% solution of the surfactant poloxamer 188), povidone-iodine, and saline are agents that are used to aid in the removal of silicone gel from tissue. The purpose of this study was to compare the efficacy of silicone gel removal by these three agents in vitro. Shur-Clens, povidone-iodine, and saline were compared as solvents for silicone gel. Four weight increments of silicone gel (0.02 g, 0.04 g, 0.06 g, and 0.08 g) were placed on glass slides. These slides were placed in separate beakers containing 40 ml test solution. The slides were soaked for 1 minute with gentle agitation. The slides were removed, rinsed gently with de-ionized water, and placed in a vacuum desiccator to dry. The slides were weighed to determine the amount of silicone removed after soaking in the solution. Analysis of variance was used to determine the significance between the three solvents. The percentages of silicone gel removed for the four weight increments (0.02 g, 0.04 g, 0.06 g, and 0.08 g) in saline were 5.6%, 2.9%, 2.1%, and 5.8%, respectively. In povidone-iodine solution, the percentages were 18.9%, 25.4%, 28.8%, and 51.9%. In Shur-Clens, the percentages were 31.3%, 43.0%, 63.5%, and 79.9%. The greater percentage of silicone gel removed by Shur-Clens was significant compared with the other solutions (p < or = 0.05). Shur-Clens was shown to be a more effective solvent for removal of silicone gel in vitro. This enhanced efficacy is a result of the fact that Shur-Clens contains 20% of the surfactant poloxamer 188. The authors' clinical experience with 7 patients who underwent ruptured silicone breast implant removal demonstrated the superiority of Shur-Clens. Shur-Clens is a surfactant cleanser that is widely available, is inexpensive, and has a good safety profile. They propose the use of Shur-Clens to clean silicone gel spillage to decrease local complications resulting from residual silicone gel.

Breast↗
PubMed2002

Determination of the solubility of perfluorocarbon liquids in silicone oil in vitro and in vivo.

PURPOSE: To investigate the solubility of perfluorocarbon liquids (PFCL) in silicone oil. METHODS: Forty-eight samples of silicone oil (1,300 mPas, n = 22; 5,000 mPas, n = 26) were analyzed for dissolved fluorocarbon molecules after surgical removal from patients who had initially undergone vitreoretinal surgery with (n = 41) and as control without (n = 7) the use of perfluorodecalin in headspace gas chromatography. In vitro, the solubility of three different PFCL-perfluorooctane (PFO), perfluorodecalin (PFD), and fluoromethylcyclohexane (FMCH)-in silicone oil of various viscosities was determined. The diffusion phenomena during a direct exchange were studied. RESULTS: In 39 of 41 silicone oil samples removed from patients who had undergone vitreoretinal surgery with the use of PFD, small amounts of dissolved perfluorocarbons could be detected. The mean value in 5,000-mPas silicone oil was 939.0 x 10-4 m/% and in 1,300-mPas silicone oil was 322.75 x10(-4) m/%. No perfluorocarbon molecules were found in seven control patients. In vitro, the following maximum solubilities in 1,000-mPas silicone oil were measured at room temperature: PFO, 3.2 m/%; PFD, 5.1 m/%; and FMCH, 10.3 m/%. The maximum values measured in 5,000-mPas silicone oil were PFO, 3.3 m/%; PFD, 5.7 m/%; and FMCH, 8.5 m/%; and in 100-mPas silicone oil were PFO, 2.4 m/%, and PFD, 5.1 m/%. CONCLUSION: Perfluorocarbon liquids dissolve in silicone oil. This may lead to transient formation of "heavy silicone oil," but no stable heavy silicone oil can be created adding PFCL. Intraocularly, retained PFCL vanish in silicone oil and are removed during silicone oil removal.

Chromatography, Gas↗
PubMed2005

An experimental study on the effect of encircling band procedure on silicone oil emulsification.

AIM: Silicone oil is a useful tamponading material used in complex vitroretinal surgery. However, the use of silicone oil is associated with emulsification which can lead to vision threatening complications. The authors developed an experimental model to study the effect of encircling band on silicone oil emulsification. METHODS: Two identical artificial eye chambers were constructed with circumferential indentations placed at the sphere's equator (mimicking an encircling band indentation), and filled with varying amounts of Silicone Oil 1000 centistrokes (Adato, Bausch and Lomb, UK) and balanced salt solution. The chambers were then placed on a horizontal rotating shaker, mimicking physiological saccadic eye movements, which spun the chambers at 100 Hz for 5 days at 37 degrees C. Emulsification was then quantified by dark field microscopy, digital photography, and manual counting by a masked observer. RESULTS: The mean (standard deviation (SD)) values of silicone emulsification bubbles were as follows: in the 90% silicone oil filled chamber with no encircling band, 139.1 (SD 313.4); in the 90% silicone oil filled chamber with encircling band, 10.9 (SD 22.2) (p<0.0001); in the 75% silicone oil filled chamber with no encircling band, 103.6 (SD 272.6); in the 75% silicone oil filled chamber with encircling band, 18.5 (SD 32), (p = 0.001). CONCLUSIONS: The emulsification of silicone oil results from friction between the silicone oil and aqueous liquids. The results from this study suggest silicone oil emulsification is reduced by (1) more complete silicone oil fill and (2) indentation from an encircling band. The authors hypothesise that both these measures resulted in reduced emulsification by reducing silicone oil/aqueous movement and resulting shearing forces.

Emulsions↗
PubMed2000

Silicone oil removal strategies.

Although it is widely accepted to use silicone oil in the treatment of very complex retinal detachments, there is no definite agreement on when and why silicone oil should be removed. Frequently found is a statement on the necessity of silicone oil removal after a certain period of time. However, the rate of retinal redetachment after silicone oil removal varies widely and appears to correlate with the underlying disease process and its severity. The literature on strategies of silicone oil removal, the rate of complications, and, thus, the risk-benefit ratio is scant. Therefore, for the discussion of silicone oil removal we rely on personal experience and the rather rare studies on silicone oil removal. Regarding the data given in the literature, the rate of vitreoretinal complications after silicone oil removal, even in cases with a clinically stable-appearing retinal situation, is rather high in severe proliferative vitreoretinopathy (PVR) and lower in most advanced cases of severe proliferative diabetic retinopathy (PDR) requiring silicone oil tamponade. The benefits of silicone oil removal are better in cases of cytomegalovirus retinitis or other situations without a PVR component. Silicone oil removal has to be considered a procedure of ill-defined risks, especially if silicone oil is really used as a last therapeutic resort in most severe cases of complicated retinal detachment. Further, exact criteria for the timing and safe removal of silicone oil in these complex vitreoretinal disorders still needs to be defined. A strategy for the removal of silicone oil is discussed.

Humans↗
PubMed1997

The influence of silicone implantation on type II collagen-induced arthritis in mice.

OBJECTIVE: To determine whether silicone implantation exacerbates autoimmune disease in a murine experimental model of arthritis. METHODS: DBA/1 mice were implanted with silicone in the form of an elastomer, gel, or oil, and immunized with type II collagen. The influence of silicone implantation on collagen-induced arthritis and the immune response to type II collagen were determined by comparison against control mice receiving sham implantation. Adjuvant effects of silicone implantation were examined by measuring cytokine levels in implanted animals and assessing autoantibodies against proteins extracted from recovered silicone implants. RESULTS: No adverse influence of silicone implantation on the clinical aspects of collagen-induced arthritis was observed. Further, polydimethylsiloxane silicone oil failed to serve as an adjuvant in the immune or arthritogenic response to type II collagen in mice. Cytokine analysis indicated that tumor necrosis factor alpha levels were lower and interleukin-2 levels were higher in silicone-implanted mice. The development of arthritis increased protein binding to implanted elastomers and gel, and autoantibodies against silicone-bound proteins were present in sera from arthritic mice and absent in sera from nonarthritic mice. CONCLUSION: The data suggest that silicone implantation may result in autoantibodies against silicone-bound proteins, and the presence of arthritis may either provoke or increase the level of such autoantibodies. However, silicone implantation did not increase the incidence or severity of disease compared with sham-operated controls. Thus, it appears that autoantibodies against silicone-bound proteins may not have pathologic significance in this experimental model of arthritis.

Animals↗
PubMed1985

Silicone granulomas: report of three cases and review of the literature.

Since silicone is rapidly becoming one of the most commonly used biomaterials in modern medicine, pathologists will be observing increasing numbers of cases of silicone-related disease. Although numerous case reports have established that silicone elicits a characteristic response in tissues, the varying tissue reactions to silicone gels, liquids, and elastomers (rubber) have not been emphasized. Three cases are reported, and the literature is reviewed to illustrate the varying features of tissue reaction to silicone in its different forms. The first case is an example of silicone lymphadenopathy in an inguinal lymph node. This case demonstrates exuberant foreign body granuloma formation in response to particles of silicone elastomer. The second case involves a patient who had facial subcutaneous liquid silicone injections, and the third case is that of a woman in whom breast carcinoma developed 13 years after mammary augmentation with liquid silicone injections. These two cases illustrate the characteristic reaction to silicone liquid, with numerous cystic spaces and vacuoles in the soft tissues but minimal or no foreign body giant cell reaction. Scanning electron microscopy and energy dispersive x-ray analysis were performed in the first two cases, confirming the presence of silicon. Silicone migration and the clinical significance of various silicone-induced lesions are discussed.

Adult↗