To the Editor.
—A letter by Paylor and Peyman reporting a case of bullous keratopathy in an aphakic patient who underwent treatment of retinal detachment with silicone oil injection was published in the December 1985 issue of the Archives.1 The authors propose a fluorescein dye test for better visualization of the silicone oil/ aqueous interface at slit lamp examination. Basically, we believe this can be a useful method to locate the anterior face of the silicone oil bubble. However, we feel that in the case of the patient who was described it is very clear that the silicone oil was not in contact with the endothelium of the cornea. Bullous keratopathy in combination with silicone oil contact to the endothelium is only seen in very late stages of silicone oil keratopathy with vascular ingrowth and gradual stromal thickening from the periphery of the cornea toward the center.2 Early
Beekhuis WH, van Rij G, Živojnović R. Silicone Oil in the Anterior Chamber of the Eye. Arch Ophthalmol. 1986;104(6):793. doi:10.1001/archopht.1986.01050180023004