Perfluorocarbon-Assisted Emulsified Silicone Oil Removal: A Simple and Effective Technique

Purpose: To describe and evaluate a perfluorocarbon liquid (PFCL)-assisted technique for removal of emulsified silicone oil following vitreoretinal surgery. Methods: This retrospective interventional case series conducted at a single vitreoretinal center included 20 eyes with significant emulsified silicone oil following long-term tamponade. PFCL was used intraoperatively to mobilize and evacuate residual silicone oil droplets. Clinical outcomes included residual emulsified oil, intraocular pressure, and best-corrected visual acuity over a mean follow-up of 24.2 months. Results: At final follow-up, 17 eyes (85%) showed complete clearance of visible emulsified silicone oil. Sparse microscopic droplets persisted in 3 eyes (15%) without clinical significance. No eye developed elevated intraocular pressure (>21 mmHg) or corneal complications. Best-corrected visual acuity improved or remained stable in all eyes, with 65% achieving an improvement of ≥2 Snellen lines. Conclusion: PFCL-assisted washout may represent a practical adjunctive technique for managing emulsified silicone oil in challenging cases, achieving high rates of clinical clearance with a favorable safety profile. Larger prospective studies are required to validate these findings.