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Postoperative panophthalmitis represents one of the most severe complications following vitreoretinal surgery, especially when the globe contains silicone oil. Consequently, a recent case report details a rare progression from endophthalmitis to panophthalmitis in a 42-year-old woman. Although silicone oil usually acts as a barrier to infection, this case highlights that vision-threatening inflammation can still transcend the intraocular space. Indeed, the patient presented two weeks post-pars plana vitrectomy with symptoms like rapidly progressive ocular pain and periocular swelling. Furthermore, clinical findings also included proptosis and restricted extraocular motility. As a result, B-scan ultrasonography confirmed dense inflammatory opacities within the silicone oil-filled vitreous cavity. Moreover, despite aggressive broad-spectrum antibiotics, the visual outcome remained poor. Because the infection spread rapidly, the eye progressed toward a pre-phthisical state.
Managing postoperative panophthalmitis in eyes filled with silicone oil involves significant technical hurdles. Specifically, diagnostic sampling is more difficult through heavy tamponades. Additionally, the presence of silicone oil may alter the distribution and clearance of intravitreal antibiotics. Therefore, clinicians must maintain a high index of suspicion when inflammatory symptoms emerge post-vitrectomy. Similarly, the literature review confirms that visual outcomes for these patients often remain guarded. However, early intervention remains the cornerstone of any attempt at eye salvage. In conclusion, while rare, this condition requires immediate and multidisciplinary attention. Thus, physicians should carefully monitor high-risk patients following complex retinal procedures.
Endophthalmitis involves inflammation of the internal coats of the eye, whereas panophthalmitis extends to the entire globe and the surrounding orbital tissues.
Silicone oil acts as a physical barrier that compartmentalizes the eye and possesses certain antimicrobial properties against common pathogens.
Treatment typically involves systemic and intravitreal broad-spectrum antibiotics, though surgical removal of the silicone oil may sometimes be necessary to clear the infection.
Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice or a professional relationship. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.
References
1. AlTahan FA et al. Postoperative Panophthalmitis in a Silicone Oil-Filled Eye: A Case Report and Review of the Literature. Ocul Immunol Inflamm. 2026 May 28. doi: 10.1080/09273948.2026.2681735. PMID: 42207563.
2. Moutei H et al. Challenges and Management Strategies for Endophthalmitis in Silicone Oil-filled Eyes: A Comprehensive Narrative Review. Journal of Advances in Medicine and Medical Research. 2025.
3. Yan H et al. Endophthalmitis in silicone oil-filled eye: A case report. World Journal of Clinical Cases. 2024;12(1):156-161.
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