When Silicone Oil Goes Anterior: A Case of Anterior Segment Neovascularization After Complex Retinal Detachment Repair.

Silicone oil is widely used for intraocular tamponade in complicated retinal detachment surgery. Despite the efficacy of this treatment, complications may occur, including emulsification of the silicone oil in the anterior chamber. Chronic ischemia from recurrent retinal detachment or the development of proliferative vitreoretinopathy places an eye at risk for the development of iris rubeosis and/or intralenticular neovascularization. An 81-year-old pseudophakic female presented with a chief complaint of blurry vision in the left eye (OS) with no light perception in the right eye (OD) since retinal reattachment surgery OD. Review of her ocular history, including outside ophthalmic records, documented pars plana vitrectomy with silicone oil tamponade for retinal detachment complicated by grade C proliferative vitreoretinopathy. She was pseudophakic in both eyes, with a history of complicated cataract extraction and a compromised posterior capsule in the right eye. The silicone oil migrated into the anterior chamber via a compromised posterior capsule. She subsequently developed iris and intralenticular neovascularization. Silicone oil tamponade with vitrectomy is a standard procedure used for complicated retinal detachments associated with proliferative vitreoretinopathy, proliferative diabetic retinopathy, complex retinal tears, or ocular trauma. However, complications have commonly been reported. We present a patient who exhibited silicone oil emulsification with concomitant neovascularization of the iris and lens secondary to ischemia from complicated retinal detachment repair.