Swept-Source Anterior Segment Oct For Detection Of Subclinical Silicone Oil Emulsification And Endothelial Deposits After Retinal Detachment Surgery

To evaluate early silicone oil emulsification using swept-source anterior segment optical coherence tomography (SS-AS-OCT) after pars plana vitrectomy for retinal detachment repair. We aimed to characterise anterior chamber and corneal endothelial changes undetectable on routine slit-lamp examination and to assess their potential clinical relevance.

This single-centre prospective study was conducted at a high-volume referral centre.

Twenty-five eyes from twenty-five patients undergoing pars plana vitrectomy with first-time 5000 cSt silicone oil tamponade for retinal detachment were included. Anterior segment imaging was performed using SS-AS-OCT (Anterion, Heidelberg Engineering), with a 23-scan protocol at the initial postoperative visit, and at 1 and 3 months postoperatively. Posterior segment OCT was conducted concurrently.

SS-AS-OCT detected silicone oil emulsification in all eyes, often evident at the first postoperative visit. In most cases, slit-lamp biomicroscopy revealed no clinically apparent anterior segment changes. Imaging identified hyperreflective droplets within the aqueous humour and fine deposits adherent to the corneal endothelium, consistent with early endothelial contact. In one case, anterior migration required immediate anterior chamber washout without endothelial damage.

Silicone oil emulsification manifests early and may remain unnoticed on routine examination. SS-AS-OCT enables the detection of subclinical anterior chamber droplets and endothelial deposits not visible at the slit lamp. These findings enhance postoperative assessment and may contribute to more individualised postoperative management.