Silicone Oil Clouding After Macular Hole Surgery With Plasma Rich Growth Factors

We report the case of a woman in her fifties with high myopia and macular telangiectasia type 2 who presented with a large full‑thickness macular hole (MH) in the right eye. She underwent combined phacoemulsification and pars plana vitrectomy with an inverted internal limitant membrane flap and adjunctive plasma rich in growth factors (PRGF), followed by silicone oil (SO) tamponade. At two days postoperatively, the SO exhibited early clouding suggestive of sudden whitening and emulsification, prompting the patient for surgery and SO removal. At two months, the MH was anatomically closed, although with persistent ellipsoid zone disruption and limited visual recovery. This case highlights a potential interaction between PRGF‑derived proteins and SO leading to clouding, an effect not previously described. Clinicians should be aware of this possible complication when selecting tamponade agents in surgery involving PRGF adjuvant.