The physical and surgical aspects of silicone oil in the vitreous cavity

  • J. Petersen
Original Investigations

Abstract

Silicone oil inside the vitreous cavity exerts forces on to the retina as a result of buoyancy, volume displacement, and surface tension. Surface tension rather than viscosity is the key to understanding why the oil seals retinal breaks effectively. The physics of the tamponade was studied quantitatively. Retinal traction can be counteracted by the oil up to a calculated threshold value, depending on the size and shape of the tear, the strength of the surface tension and, most importantly, the distance between the retina and choroid. For a nearly flat retinal hole, the tamponade is very effective. These theoretical results imply straightforward rules for surgery, rules that have been tested in 150 operations. An attempt must be made to fill 100% of the vitreous cavity. Since the air-water boundary has 3 times the surface tension of the water-oil boundary, the most effective procedure is to flatten the retina by means of a fluid-gas exchange and then clamp it in a flat position, implanting the silicone oil. Silicone in the subretinal space or the anterior chamber tends to retract spontaneously, for surface tension causes the smaller bubble to blow up the larger one. Surgical methods are described to make use of it.

Keywords

Surface Tension Retina Anterior Chamber Effective Procedure Small Bubble 

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References

  1. 1.
    Ando F (1985) Intraocular hypertony resulting from pupillary block by silicone oil. Am J Ophthalmol 99:87–88PubMedGoogle Scholar
  2. 2.
    Ando F, Kondo J (1983) A plastic tack for the treatment of retinal detachment with giant tears. Am J Ophthalmol 95:260–261PubMedGoogle Scholar
  3. 3.
    Charles S (1981) Vitreous micorsurgery. Williams & Wilkins, Baltimore LondonGoogle Scholar
  4. 4.
    Cibis PA, Becker B, Okun E, Canean S (1962) The use of liquid silicone in retinal detachment surgery. Arch Ophthalmol (New York) 68:590–599Google Scholar
  5. 5.
    Gnad H (1986) An intraocular balloon for silicone oil implantation. Graefe's Arch Clin Exp Ophthalmol 224:32–33CrossRefGoogle Scholar
  6. 6.
    Gnad H, Klemen UM, Radda TM (1983) Healon als innere Tamponade der Netzhautchirurgie. Klin Monatsbl Augenheilkd 183:184–186PubMedGoogle Scholar
  7. 7.
    Gonvers M (1985) Temporary silicone oil tamponade in the management of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol 100:239–245PubMedGoogle Scholar
  8. 8.
    Haut J, Larricart JP, Van Effenterre G, Pinon-Pignero FL (1985) Some of the most important properties of silicone oil to explain its action. Ophthalmologica 191: 150–153PubMedGoogle Scholar
  9. 9.
    Joos G (1959) Lehrbuch der theoretischen Physik. Akademische Verlagsgesellschaft, Frankfurt/Main, pp 209–214Google Scholar
  10. 10.
    Landers MB III, Robinson D, Olsen KR, Rinkoff J (1985) Slit-lamp fluid-gas exchange and other office prodedures following vitreoretinal surgery. Arch Ophthalmol 103:967–972PubMedGoogle Scholar
  11. 11.
    Machemer R, Parel JM, Norton EWD (1972) Vitrectomy: a pars plana approach. Technical improvements and further results. Trans Am Acad Ophthalmol Otolaryng 76:462–467Google Scholar
  12. 12.
    Petersen J (1986) Silikon-Öl in der Vorderkammer des aphaken Auges: Vermeiden und Beheben dieser Komplikation. Fortschr Ophthalmol 83:587–589PubMedGoogle Scholar
  13. 13.
    Pohl RW (1969) Mechanik, Akustik, Wärmelehre. Springer, Berlin Heidelberg New York, pp 114–138Google Scholar
  14. 14.
    Scott JD (1975) The treatment of massive vitreous retraction by separation of preretinal membranes using liquid silicone. Mod Probl Ophthalmol 15:285–290Google Scholar
  15. 15.
    Scott JD (1977) A rationale for the use of liquid silicone. Trans Ophthalmol Soc UK 97: 235–237PubMedGoogle Scholar
  16. 16.
    Scott JD (1981) Use of liquid silicone in vitrectomized eyes. Dev Ophthalmol 2: 185–190PubMedGoogle Scholar
  17. 17.
    Stenkula S, Ivert L (1984) Sodium hyaluronate (Healon) as an intravitreal aid in retinal and vitreous surgery. J Ocular Ther Surg 12:109–114Google Scholar
  18. 18.
    Yoshizumi MO, Dunn B, Ligh JK, Altaian RM (1985) Physical properties of vitamin E oil and silicone oil. Retina 5:163–167PubMedGoogle Scholar
  19. 19.
    Zivojnovic R, Mertens DA, Peperkamp E (1982) Das flüssige Silikon in der Amotiochirurgie. II. Bericht über 280 Fälle — weitere Entwicklung der Technik. Klin Monatsbl Augenheilkd 181:444–452PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • J. Petersen
    • 1
  1. 1.Universitäts-AugenklinikGöttingenFederal Republic of Germany

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