Silicone topical gel

PurposeTo evaluate the incidence, mechanisms, and clinical implications of silicone oil droplet transmission during intravitreal anti-vascular endothelial growth factor injections and to review strategies to mitigate contamination risks.MethodsA systematic review of observational and review studies from PubMed and MEDLINE was conducted, focusing on incidence, contributing factors, and clinical outcomes of silicone oil contamination during IVIs. Specific attention was given to syringe design, storage conditions, variations among anti-vascular endothelial growth factor agents, and injection techniques.ResultsThe review found that prevalence is high in chronically injected eyes, although per-injection rates are low, often clustering because of syringe batches or techniques. Contributing factors include freeze-thaw cycles, mechanical agitation, spray-siliconized low dead space syringes, and improper plunger handling, which can lead to asymptomatic droplets or symptomatic floaters. No severe complications such as endophthalmitis were reported. Hypotheses link silicone oil to ocular hypertension or inflammation via trabecular obstruction or immunogenic responses, but the reviewed studies show no direct evidence. Mitigation involves the use of silicone-free/prefilled syringes, strict storage, gentle handling, and refined techniques such as priming and smooth plunger depression.ConclusionSilicone oil contamination during IVIs can be minimized through careful optimization of syringe design, handling practices, and injection techniques. Embracing silicone-free or low-silicone syringe systems, alongside meticulous procedural protocols, offers the potential to enhance the safety and clinical outcomes of intravitreal anti-vascular endothelial growth factor therapy.

Abstract licence: CC BY-NC-ND

BackgroundAlthough silicone gel combined with laser therapy is commonly used for scar management, its comparative efficacy and safety versus monotherapy remain uncertain.MethodsThis meta-analysis (CRD420251008217) searched PubMed, Embase, the Cochrane Library, and Chinese databases from database inception to February 6, 2025, for randomized controlled trials (RCTs) comparing silicone gel plus laser therapy with either modality alone in patients with scars. Risk of bias was assessed using the Cochrane risk of bias 2.0 tool. Outcomes encompassed the Vancouver Scar Scale (VSS), absolute scar height, pain/pruritus scores, satisfaction, and safety. A random-effects model was used for outcomes with high heterogeneity (I 2 > 50%); otherwise, a fixed-effects model was applied. Efficacy of silicone gel combined with different laser types was compared using Bayesian network meta-analysis.ResultsForty-five RCTs (3806 participants) were included; 40 RCTs were eligible for quantitative analysis. Forty-four studies were at high risk of bias. Compared with monotherapy, silicone gel plus laser therapy significantly reduced VSS scores at 6 months (standardized mean difference = -1.33; 95% confidence interval, -1.85 to -0.81) and improved patient satisfaction (odds ratio=4.21; 95% confidence interval, 1.91-9.24). These findings remained consistent across subgroups. Silicone gel plus laser therapy had fewer treatment-emergent adverse events than monotherapy. In ranking probabilities, silicone gel plus nonablative laser ranked first in improving VSS scores at 6 months and VSS score reduction from baseline to 6 months posttreatment.ConclusionsSilicone gel plus laser therapy demonstrated improved efficacy and safety over monotherapy, with consistent benefits across multiple subgroups.

Abstract licence: CC BY-NC-ND