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Primary vitrectomy with Densiron-68 for rhegmatogenous retinal detachment

  • M. R. RomanoEmail author
  • T. Stappler
  • J. Marticorena
  • C. Groenewald
  • I. Pearce
  • S. K. Gibran
  • D. Wong
  • H. Heimann
Retinal Disorders

Abstract

Background

To report a retrospective non-comparative interventional study on the effectiveness and ocular tolerance of a heavy silicone oil tamponade (HSO, Densiron-68) for primary inferior rhegmatogenous retinal detachment (RRD).

Methods

Forty-one eyes of 41 consecutive patients were recruited between January 2004 and August 2006. Primary vitrectomy with Densiron-68, a heavy silicone oil, was used in all cases. Inclusion criteria were primary RRD with at least one retinal break between 4 and 8 clock hours. The study protocol consisted of a minimum of eight clinic visits: baseline, surgery, 1 week, 1 month and 3 months after the initial surgery; removal of oil and 1 week, 1 month and 3 months postoperatively. The primary endpoint was anatomical re-attachment of the retina. Cases were judged successful when there was reattachment of the retina in the absence of any tamponade agent. The secondary endpoint was to record the visual function and any complications arising from the surgery. Out of 41 patients initially included in the study, 33 completed all follow-up visits.

Results

Anatomical success was achieved in 91% of cases (30 out of 33) with one retinal operation, and rose to 94% (31 out of 33) with additional surgery. Mean visual acuity improved from logMAR 1.19 (SD 0.9) to 0.5 (SD 0.51, p = 0.001). No significant ocular hypertension, clinically significant emulsification of the tamponade or inflammation developed during follow-up.

Conclusion

With Densiron-68, high anatomical and functional success rates can be achieved with primary vitrectomy for RRD and predominantly inferior pathology.

Keywords

Semifluorinated alkanes Perfluorohexyloctane Primary inferior Rhegmatogenous retinal detachment Heavy silicon oil 

Notes

Acknowledgement

The authors indicate no financial support or financial conflict of interest. Involved in conception, design of the study and data analysis were MRR, DW, TS, HH; involved in collection and management of the data were JM, IAP, CGR, GSK; involved in the provision of patients were IAP, CGR, GSK; involved in the preparation of the manuscript were MRR, TS, HH; and involved in the review and approval of the manuscript were DW, TS, HH.

References

  1. 1.
    Alexander P, Ang A, Poulson A, Snead MP (2008) Scleral buckling combined with vitrectomy for the management of rhegmatogenous retinal detachment associated with inferior retinal breaks. Eye 23(2):200–203CrossRefGoogle Scholar
  2. 2.
    Arya AV, Emerson JW, Engelbert M, Hagedorn CL, Adelman RA (2006) Surgical management of pseudophakic retinal detachments: a meta-analysis. Ophthalmology 113(10):1724–1733PubMedCrossRefGoogle Scholar
  3. 3.
    Azen SP, Scott IU, Flynn HW Jr et al (1998) Silicone oil in the repair of complex retinal detachments. A prospective observational multicenter study. Ophthalmology 105(9):1587–1597PubMedCrossRefGoogle Scholar
  4. 4.
    Cibis PA, Becker B, Okun E et al (1962) The use of liquid silicone in retinal detachment surgery. Arch Ophthalmol 68:46–55CrossRefGoogle Scholar
  5. 5.
    Fawcett IM, Williams RL, Wong D (1994) Contact angles of substances used for internal tamponade in retinal detachment surgery. Graefes Arch Clin Exp Ophthalmol 232:438–444PubMedCrossRefGoogle Scholar
  6. 6.
    Heimann H, Stappler T, Wong D (2008) Heavy tamponade 1: a review of indications, use and complications. Eye, Mar 14 [Epub ahead of print]Google Scholar
  7. 7.
    Heimann H, Bartz-Schmidt KU, Bornfeld N, Weiss C, Hilgers RD, Foerster MH, Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment Study Group (2007) Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology 114:2142–2154PubMedCrossRefGoogle Scholar
  8. 8.
    Herbrig E, Sandner D, Engelmann K (2007) Anatomical and functional results of endotamponade with heavy silicone oil - Densiron-68 - in complicated retinal detachment. Ophthalmic Res 39:198–206PubMedCrossRefGoogle Scholar
  9. 9.
    Hoerauf H, Roider J, Kobuch K, Laqua H (2005) Perfluorohexylethan (O62) as ocular endotamponade in complex vitreoretinal surgery. Retina 25(4):479–488PubMedCrossRefGoogle Scholar
  10. 10.
    Lucke KH, Foerster MH, Laqua H (1987) Long-term results of vitrectomy and silicone oil in 500 cases of complicated retinal detachments. Am J Ophthalmol 104(6):624–633PubMedGoogle Scholar
  11. 11.
    Machemer R, Aaberg TM, Freeman HMK et al (1991) An updated classification of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol 112:159–165PubMedGoogle Scholar
  12. 12.
    Majid MA, Hussin HM, Biswas S, Haynes RJ, Mayer EJ, Dick AD (2008) Emulsification of Densiron-68 used in inferior retinal detachment surgery. Eye 22:152–157PubMedCrossRefGoogle Scholar
  13. 13.
    Martinez-Castillo V, Verdugo A, Boixadera A et al (2005) Management of inferior breaks in pseudophakic rhegmatogenous retinal detachment with pars plana vitrectomy and air. Arch Ophthalmol 123:1078–1081PubMedCrossRefGoogle Scholar
  14. 14.
    Riedel KG, Gabel VP, Neubauer L et al (1990) Intravitreal silicone oil injection: complications and treatment of 415 consecutive patients. Graefes Arch Clin Exp Ophthalmol 228(1):19–23PubMedCrossRefGoogle Scholar
  15. 15.
    Rizzo S, Genovesi-Ebert F, Vento A, Cresti F, Di Bartolo E, Belting C (2007) A new heavy silicone oil (HWS 46–3000) used as a prolonged internal tamponade agent in complicated vitreoretinal surgery: a pilot study. Retina 27(5):613–620PubMedCrossRefGoogle Scholar
  16. 16.
    Rosen PH, Wong HC, McLeod D (1989) Indentation microsurgery: internal searching for retinal breaks. Eye 3:277–281PubMedCrossRefGoogle Scholar
  17. 17.
    Sandner D, Herbrig E, Engelmann K (2007) High-density silicone oil (Densiron) as a primary intraocular tamponade: 12-month follow up. Graefes Arch Clin Exp Ophthalmol 245:1097–1105PubMedCrossRefGoogle Scholar
  18. 18.
    Sharma A, Grigoropoulos V, Williamson TH (2004) Management of primary rhegmatogenous retinal detachment with inferior breaks. Br J Ophthalmol 88(11):1372–1375PubMedCrossRefGoogle Scholar
  19. 19.
    Tanner V, Minihan M, Williamson TH (2001) Management of inferior retinal breaks during pars plana vitrectomy for retinal detachment. Br J Ophthalmol 85(4):480–482PubMedCrossRefGoogle Scholar
  20. 20.
    Tewari HK, Kedar S, Kumar A, Garg SP, Verma LK (2003) Comparison of scleral buckling with combined scleral buckling and pars plana vitrectomy in the management of rhegmatogenous retinal detachment with unseen retinal breaks. Clin Experiment Ophthalmol 31(5):403–407PubMedCrossRefGoogle Scholar
  21. 21.
    Wetterqvist C, Wong D, Williams R, Stappler T, Herbert E, Freeburn S (2004) Tamponade efficiency of perfluorohexyloctane and silicone oil solutions in a model eye chamber. Br J Ophthalmol 88(5):692–696PubMedCrossRefGoogle Scholar
  22. 22.
    Wickham L, Connor M, Aylward GW (2004) Vitrectomy and gas for inferior break retinal detachments: are the results comparable to vitrectomy, gas, and scleral buckle? Br J Ophthalmol 88:1376–1379PubMedCrossRefGoogle Scholar
  23. 23.
    Williams R, Wong D (1999) The influence of explants on the physical efficiency of tamponade agents. Graefes Arch Clin Exp Ophthalmol 237:870–874PubMedCrossRefGoogle Scholar
  24. 24.
    Wolf S, Schon V, Meier P, Wiedemann P (2003) Silicone oil-RMN3 mixture (“heavy silicone oil”) as internal tamponade for complicated retinal detachment. Retina 23(3):335–342PubMedCrossRefGoogle Scholar
  25. 25.
    Wong D, Billington BM, Chignell AH (1987) Pars plana vitrectomy for retinal detachment with unseen retinal holes. Graefes Arch Clin Exp Ophthalmol 225:269–271PubMedCrossRefGoogle Scholar
  26. 26.
    Wong D, Kumar I, Quah SA, Ali H, Valdeperas X, Romano MR (2007) Comparison of postoperative intraocular pressure in patients with Densiron-68 vs conventional silicone oil: a case-control study. Eye, Dec 7 [Epub ahead of print]Google Scholar
  27. 27.
    Wong D, Van Meurs JC, Stappler T, Groenewald C, Pearce IA, McGalliard JN et al (2005) A pilot study on the use of a perfluorohexyloctane/silicone oil solution as a heavier than water internal tamponade agent. Br J Ophthalmol 89(6):662–665PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • M. R. Romano
    • 1
    Email author
  • T. Stappler
    • 1
  • J. Marticorena
    • 1
  • C. Groenewald
    • 1
  • I. Pearce
    • 1
  • S. K. Gibran
    • 1
  • D. Wong
    • 1
  • H. Heimann
    • 1
  1. 1.St. Paul’s Eye UnitRoyal Liverpool University HospitalLiverpoolUK

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