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

Omer Othman Abdullah Department of Vitreoretinal Surgery, Ibinsina Modern Eye and Retina Center, Erbil, IraqCorrespondence: Omer Othman Abdullah, Ibinsina Modern Eye and Retina Center, Erbil, Iraq, Tel +9647501206673, Email [email protected]: 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.Plain Language Summary: Silicone oil is commonly used during retinal surgery to support healing, but over time it can break into tiny droplets that are difficult to remove and may cause increased eye pressure or vision problems. Traditional removal methods often fail to completely clear these droplets.This study describes a surgical technique that uses a heavy liquid, called perfluorocarbon liquid, to more effectively wash out emulsified silicone oil from the eye. The technique was applied in 20 patients who developed significant silicone oil emulsification after previous retinal surgery.In most patients, visible silicone oil droplets were successfully removed. Eye pressure remained stable, and vision either improved or stayed the same during long-term follow-up. No serious complications related to the technique were observed.This approach may help surgeons remove emulsified silicone oil more safely and thoroughly, potentially reducing long-term eye complications for patients.Keywords: silicone oil emulsification, perfluorocarbon liquid, vitreoretinal surgery, intraocular pressure, anterior chamber, emulsified oil removal