Silicone Oil in the Surgical Management of Endophthalmitis



A randomized prospective study was designed to determine the role of silicone oil in the surgical management of endophthalmitis.


The study subjects were 42 patients in whom clinical signs of endophthalmitis developed within 6 weeks of cataract surgery (phacoemulsification) or secondary lens implantation. All patients had advanced, severe endophthalmitis. They were randomly assigned to treatment with pars plana vitrectomy with or without silicone oil. Preoperative visual acuity in all patients was light perception. The mean follow-up time was 1 year. Twenty-two patients recieved silicone oil (1000cSt) and 20 had only balanced salt solution (BSS). Both groups recieved infusion fluid containing antibiotics and corticostreroids during the vitrectomy; postoperatively, topical antibiotics, cycloplegics, corticosteroids and systemic antibiotics and corticostreroids were administered.


Data from the trial show that the media cleraed much more quickly in the silicone oil group; all eyes in the silicone oil group had clear media, while only 70% in the BSS group had completely clear media. During the follow-up period, there was no retinal detachment in the silicone oil group, but the incidence in the BSS group was 20%. During the entire course of the study, none of the silicone oil group required additional surgery; 40% of the BSS group had additional surgery. The visual acuity was better in the silicone group than the BSS group (p0.01)


The results of this study indicate that silicone oil can be considered in the surgical management of advanced and severe cases pf endophthalmitis. The more rapid clearing of the media with silicone oil could be of clinical importance for certain patients.



Murat Oncel
Istanbul, Turkey
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