Cataract extraction in eyes filled with silicone oil.

A surgical technique for cataract extraction in eyes filled with silicone oil was developed that has two major objectives: removal of the entire cataractous lens and complete preservation of the silicone oil volume. A regular extracapsular cataract extraction or phacoemulsification is performed, and the incision is closed with the final sutures. All steps are performed under continuous positive pressure achieved with an anterior chamber maintainer connected to a bottle of balanced saline solution. An inferior basal iridectomy is created with a vitrectomy probe, and the posterior capsule is then slowly pulled out through the limbal incision with intraocular forceps, again under positive pressure, in an eye that is actually a closed system, without any loss of silicone. This step results in transformation of the extracapsular cataract extraction condition into an intracapsular cataract extraction condition. The described technique was successfully performed in nine eyes. In the younger patients, the whole procedure was completed through two very small limbal openings.