Murat Oncel Istanbul, Turkey

Purpose:

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

Methods:

The study subject were 62 patients in whom clinical signs of endophthalmitis developed within 6 weeks of cataract surgery 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 pateints was light perception The mean follow-up time was two years. 32 patients recieved silicone oil and 30 patients had only balanced salt solution (BSS). Both groups recieved infusion fluid containing antibiotics and corticosteroids during the vitrectomy; postoperatively, topical antibiotics, cycloplegics, corticosteroids, and systemic antibiotics and corticosteroids were administered. Results: Data from trial show that the media cleared much more quickly in the silicone oil group; all eyes in the silicone oil group had clear media, while only 83% in the BSS group had completely clear media. During the follow-up period, there was 3% retinal detachment in the silicone oil group but the incidence in the BSS group was 16%. During the entire course of the study, 6% of the silicone group required additional surgery; 50% of the BSS group had additional surgery.

Conclusion:

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