Pilocarpine aiding the management of early post-operative silicon oil migration into the anterior chamber after vitrectomy in an aphakic child: case report

Background: Silicon oil has been used in retinal surgeries for decades. One of the observed complications after its use is a high intraocular pressure. Herein, the management of early high intraocular pressure secondary to silicon oil migration into the anterior chamber in an aphakic child post vitrectomy is described. Case presentation: An eight-year-old boy presented to the emergency department just five days post lensectomy; pars plana vitrectomy and silicon oil tamponade was done due to traumatic cataract in the left eye. He had a high intraocular pressure with massive silicon oil infiltration into the anterior chamber. He was managed conservatively with face-down position, mydriatics, and antiglaucoma drugs. Afterwards, the silicon oil retracted into the posterior pole, and the patient was given pilocarpine to constrict the pupil and prevent re-migration of silicon oil into the anterior chamber. His intraocular pressure remained controlled till it was safe to remove the silicon oil by the vitreoretinal surgeon. Conclusion: This case highlights the value of pilocarpine in the prevention of silicon oil remigration into the anterior chamber; thus creating time for safe silicon oil removal. By utilizing these conservative measures, invasive interventions can be deferred, minimizing risks and optimizing patient outcomes, particularly in the pediatric population.