Transient hypopyon with marked anterior chamber fibrin following pars plana vitrectomy and silicone oil injection
R. N. Johnson, H. W. Flynn Jr, J. M. Parel and L. M. Portugal
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, School of Medicine, FL 33136.
In a retrospective review of 30 cases of complex retinal detachment, which
had been managed by pars plana vitrectomy techniques together with silicone
oil injection, we found that two patients developed marked postoperative
anterior chamber fibrin and hypopyon. In all 30 cases, the same silicone
oil was used: purified and heat-sterilized trimethylsiloxy-terminated,
polydimethylsiloxane of 1000-centistoke viscosity. Although the silicone
oil itself remained clear and without emulsification, the differential
diagnosis of this postoperative inflammation included microbial
endophthalmitis. These two cases were treated with frequent topical
steroids and antibiotics while we closely monitored the retraction of the
anterior chamber fibrin. In both cases, clinical improvement and long-term
retinal reattachment with satisfactory visual function were achieved. The
use of intense scatter laser endophotocoagulation and the presence of
impurities in the silicone oil may have contributed to the excessive
postoperative inflammation in these cases.
