Intraocular fluid currents caused by saccadic eye and head movements exert shear stress on the retina, and this stress has been considered as a significant pathogenic mechanism that causes retinal detachment 5.
These are some of the reasons why a 100% single-surgery anatomical success rate for complicated retinal detachment with inferior proliferative vitreoretinopathy has not been reached yet 4. Therefore, the percentage of the vitreous cavity that should be filled with SO in individual cases and the postoperative positional restrictions necessary to achieve sufficient coverage by SO in the inferior retina are difficult to predict. Furthermore, the actual shape of the human vitreous cavity is not perfectly spherical, especially in myopic eyes 3. Therefore, the tamponade efficiency of SO to the inferior quadrant of the retina decreases compared with that of SO to other quadrants. As SO is less dense than water, SO has positive buoyancy and floats, and the contact angle is smaller than that of gas to the retina 2.
Silicone oil (SO) is a safe and well-tolerated intraocular tamponade agent widely used for the treatment of complicated vitreoretinal diseases such as inferior rhegmatogenous retinal detachments (RRDs), proliferative vitreoretinopathy (PVR), giant retinal tears, traumatic retinal detachments, and some cases of tractional retinal detachments 1. Taken together, these findings have clinical implications for the treatment of complicated RRDs with inferior PVR requiring SO tamponade. In all seven vitreous cavity models tested, the inferior quadrant of the retina was completely covered by SO in more positions and the absolute velocity gradient of the retro-oil fluid in contact with the retinal wall caused by eye and head movements was lower when the vitreous cavity was filled with 95% SO and 5% retro-oil fluid versus 80% SO and 20% retro-oil fluid. Here, we performed fluid simulation analysis using the moving particle semi-implicit method on the oil cover rates and absolute velocity gradient of retro-oil fluid to the retina using vitreous cavity models derived from magnetic resonance imaging of patients to determine the appropriate amount of SO and postoperative position to achieve a sufficient tamponade effect on the inferior retina. However, as the human vitreous cavity is irregularly shaped, it is difficult to predict the area of the inferior retina covered with SO and the retro-oil fluid currents in each patient. Silicone oil (SO) is a safe and widely used intraocular tamponade agent for treating complicated vitreoretinal diseases, such as retinal detachments (RRDs) with inferior proliferative vitreoretinopathy (PVR).
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