To understand why some patients seem to be protected from emulsification and others are not, the authors developed an in vitro model for quantitative analysis of silicone oil emulsification. The pro-emulsifying potential of substances and blood components that may have access to the vitreous cavity in a patient's eye was analyzed. In this model, red blood cell ghosts had the highest emulsifying effect; plasma and lymphocytes also had a significant emulsifying effect. Phospholipids in membranes and other soluble blood components may play important roles in this process. These results suggest the importance of avoiding and removing hemorrhage and avoiding inflammation when silicone oil is used in vitreoretinal surgery.