A Narrative Review of Silicone Oil-associated Macular Edema

Macular edema (ME), including cystoid macular edema (CME), is a clinically important complication of silicone oil (SO) tamponade that may limit visual recovery following complex retinal surgery.The reported frequency varies widely, ranging from 3.5% to 56.1%, reflecting heterogeneity in underlying diseases, surgical indications, study design, duration of SO tamponade, timing of optical coherence tomography (OCT) assessment, and ME/CME definitions.Reported risk factors include preoperative macula-off retinal detachment, proliferative vitreoretinopathy, longer SO tamponade duration, low-viscosity SO, and factors related to surgical complexity.The pathogenesis appears multifactorial; available evidence supports the accumulation of inflammatory mediators in the retro-oil space, whereas mechanical or metabolic effects and emulsification-related changes remain plausible but less well-established mechanisms.Pharmacologic treatment during SO tamponade may provide partial anatomical improvement in selected eyes, but responses are inconsistent.Silicone oil removal (SOR) is often associated with reduced central macular thickness or improvement in ME/CME; however, persistent edema, de novo post-SOR edema, and limited functional recovery have also been reported.Therefore, early recognition and longitudinal monitoring with OCT are important, and the decision to perform SOR and the timing of removal should be individualized according to retinal stability, redetachment risk, baseline macular pathology, and inflammatory burden.