Silicone oils compared and found wanting

Excerpt

Silicone oil was first introduced in the treatment of retinal detachment (RD) by Cibis in the 1960s and approved by the US Food and Drug Administration for intraocular use in 1994 [1]. It was approved as a medical device and its application continues to be under medical device regulations rather than as a medicine. Its use has been associated with a wide variety of complications, and in many cases, these have been thought to be toxic in origin, due to chemical impurities rather than mechanically induced [2]. Indeed, the commonest complication of oil use, emulsification is known to be significantly increased in the presence of low molecular weight polymer impurities in oil [3]. Silicone oil is typically not used as a surgical tool and occasionally left in the eye for prolonged periods including permanently. If newly invented, there is no doubt that there would have been a greater burden of proof needed for its chemical composition and impurity content. In actual fact, if it were not for the fact that oil is indispensable in some cases, its use may have been abandoned some time ago. …