Removal of silicone oil in the management of glaucoma in eyes with emulsified silicone.

Glaucoma and emulsification are two complications of silicone oil injection that are often coexisting. This study was undertaken to determine whether removal of emulsified oil has any effect on the management of the glaucoma. A comparison of eyes with and without glaucoma with emulsified oil also was undertaken. Eighteen eyes that underwent removal of emulsified silicone oil more than 6 months after the injection of the oil were reviewed. All eyes were observed for at least 6 months after removal with attached retinas. Eleven eyes had glaucoma at the time of removal. The diagnosis of glaucoma preceded the identification of emulsification in 8 of 11 eyes (73%). Removal of the emulsified oil did not affect the intraocular pressure (IOP) in 10 of the 11 (91%) glaucomatous eyes. The IOP was reduced in one patient. In the glaucoma patients, the final visual acuity was significantly reduced compared with the best corrected visual acuity obtained during the follow-up period (P = 0.016). In the nonglaucoma eyes with emulsified oil, the visual acuity did not significantly deteriorate during follow-up. At the end of the follow-up period, optic atrophy was observed in 9 of 11 (82%) of the eyes with glaucoma compared with two of seven (28%) of eyes without glaucoma. The results suggest that removal of emulsified silicone oil failed to control the glaucoma, and could not change the aggressive nature of the glaucoma in these eyes.