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Quantifying silicone oil emulsification in patients: are we only seeing the tip of the iceberg?

Graefe's Archive for Clinical and Experimental Ophthalmology volume 253, pages 1671–1675 (2015)Cite this article

Abstract

Purpose

Emulsification of silicone oil in the eye is a difficult problem. In an effort to find an objective way to quantify emulsification, we used the Coulter principle to measure silicone oil emulsified droplets from the washings of a series of patients.

Methods

Aqueous washouts after silicone oil removal were obtained from nine patients (nine eyes). We used the Coulter counter Multisizer® 4 to obtain the size distribution of the oil droplets.

Results

Over 65 % of the emulsified silicone oil droplets in the clinical samples had a diameter smaller than is detectable by light microscopy (2 μm). The median size of the droplets was between 1.1 and 1.9 μm. Based on the Spearman’s correlation coefficient (r), there was a strong correlation between the number of the droplets that cannot be seen (between 1 and 2 μm) and those that can be seen (7–30 μm) (r = 0.817, p = 0.007).

Conclusion

Once emulsification was detected clinically in the anterior chamber, extensive emulsification would have already occurred in the posterior chamber, with most of the emulsified droplets that were too small in size to be seen on clinical examination. Ostwald ripening might explain why there were so many small droplets. The predominance of small droplets might account for some of the clinical complications associated with silicone oil use.

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Conflict of interest

Financial and proprietary interest: Nil

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Authors and Affiliations

  1. Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Room 301, Level 3, Block B, Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong

    Yau Kei Chan, Ning Cheung, Wing Suet Catherine Chan & David Wong

  2. Department of Mechanical Engineering, Faculty of Engineering, University of Hong Kong, Pokfulam, Hong Kong

    Yau Kei Chan

  3. Singapore Eye Research Institute, National University of Singapore, City-State, Singapore

    Ning Cheung

  4. Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia

    Ning Cheung

Authors
  1. Yau Kei Chan
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  2. Ning Cheung
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  3. Wing Suet Catherine Chan
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  4. David Wong
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Correspondence to David Wong.

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Chan, Y.K., Cheung, N., Chan, W.S.C. et al. Quantifying silicone oil emulsification in patients: are we only seeing the tip of the iceberg?. Graefes Arch Clin Exp Ophthalmol 253, 1671–1675 (2015). https://doi.org/10.1007/s00417-014-2866-1

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  • DOI: https://doi.org/10.1007/s00417-014-2866-1

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