Extraocular silicone oil migration to orbit and retrolaminar region: case report and systematic review
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OCULOPLASTICS AND ORBIT
Extraocular silicone oil migration to orbit and retrolaminar region: case report and systematic review Stacey C. Lam 1,2
&
Alison Y. Y. Chan 1,2 & Hunter K. L. Yuen 1,2
Received: 18 June 2020 / Revised: 13 July 2020 / Accepted: 15 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Silicone oil insertion is a common modality in vitreoretinal surgeries. The purpose of this study is to conduct a systematic review to summarize the uncommon complication of extraocular silicone oil migration. Methods Following the PRISMA guidelines, a systematic review of the literature was performed on January 11, 2020, using PubMed and EMBASE with the following terms: “silicone oil,” “eye,” and “migrat*.” Results A total of 69 patients—68 patients from 59 articles and one case from our institution—were included in the final analysis. The median age was 54 years (range, 9–92) and 40 patients (57.9%) were men. Orbital migration was reported in 34 patients, and retrolaminar migration (including optic nerve, optic chiasm, suprasellar, subarachnoid space, intraventricular spaces) was reported in 35 patients. Orbital migration group had more aphakics (p = 0.007), implanted glaucoma drainage device (p = 0.005), scleral buckle (p = 0.000), history of trauma-related indications for pars plana vitrectomy (p = 0.000), shorter silicone oil endotamponade time (p = 0.008), more symptomatic (p = 0.000), and requiring surgical intervention (p = 0.000). Retrolaminar migration group had older patients (p = 0.016) and more diabetics (p = 0.041). Conclusion Systematic review sheds light on plausible risk factors on site of silicone oil migration. Majority of orbital cases are symptomatic and require intervention while retrolaminar cases are incidental and can be managed conservatively. Awareness of this complication can help guide clinicians predict which patients would likely need surgical intervention.
Keywords Silicone oil . Migration . Orbital . Neuro-ophthalmological . Complications
Introduction Silicone oil has been widely used as a tamponade agent in the treatment of complex vitreoretinal diseases. It is generally removed several weeks to months due to its associated intraocular complications—mainly cataract, band keratopathy, elevated intraocular pressure (IOP), and retinal toxicity. Other less common complications include extraocular migration of silicone oil into the orbit and retrolaminar region. Incidence of silicone oil migration to the subconjunctival space has been reported to be 3–30%, and retrolaminar * Stacey C. Lam [email protected] 1
Department of Ophthalmology, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong, China
2
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
migration of silicone oil vacuoles to optic nerve has been reported to be up to 24% in histopathological enucleated eyes [1–3]. However, major migrations to orbit and retrolaminar region into the ventricular system are uncommon. P
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