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Research Letters | Aug 2012

Orbital Silicone Oil Granuloma Discovered During Enucleation

Steven M. Couch, MD; George J. Harocopos, MD; John B. Holds, MD

Arch Ophthalmol. 2012;130(8):1083-1085. doi:10.1001/archophthalmol.2012.287.

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Silicone oil tamponade is commonly used in surgical repair of recalcitrant retinal detachments. Complications of intraocular silicone oil include corneal decompensation, cataract formation, and glaucoma.¹ Silicone oil has been reported to migrate through the optic nerve into the brain.² Free silicone oil within tissues can cause a chronic granulomatous inflammatory reaction, which, depending on the location, can result in impairment of involved structures.³^- 4 Silicone oil has been reported to cause granulomatous anterior episcleral nodules following transscleral migration through vitrectomy sites.⁴ We have found no cases of posterior orbital silicone oil granulomas incidentally discovered during enucleation.

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Figure. Gross and histologic photographs. A, Gross photograph of the enucleated globe with a large white mass extending from the posterior sclera. B, Low-magnification histologic photograph of the globe with iatrogenic scleral discontinuity (arrow) and a large silicone oil granuloma extending off the posterior sclera (asterisk) (hematoxylin-eosin, original magnification ×1). C, High-magnification histologic photograph of the posterior epibulbar mass, showing silicone oil with a granulomatous reaction characterized by giant cells (arrow) and associated lymphocytes (hematoxylin-eosin, original magnification ×400).

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Couch SM, Harocopos GJ, Holds JB. Orbital Silicone Oil Granuloma Discovered During Enucleation. Arch Ophthalmol. 2012;130(8):1083-1085. doi:10.1001/archophthalmol.2012.287.

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