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.
This is a preview of subscription content, access via your institution.
References
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):200–203
Arya AV, Emerson JW, Engelbert M, Hagedorn CL, Adelman RA (2006) Surgical management of pseudophakic retinal detachments: a meta-analysis. Ophthalmology 113(10):1724–1733
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):1587–1597
Cibis PA, Becker B, Okun E et al (1962) The use of liquid silicone in retinal detachment surgery. Arch Ophthalmol 68:46–55
Fawcett IM, Williams RL, Wong D (1994) Contact angles of substances used for internal tamponade in retinal detachment surgery. Graefes Arch Clin Exp Ophthalmol 232:438–444
Heimann H, Stappler T, Wong D (2008) Heavy tamponade 1: a review of indications, use and complications. Eye, Mar 14 [Epub ahead of print]
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 114:2142–2154
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 39:198–206
Hoerauf H, Roider J, Kobuch K, Laqua H (2005) Perfluorohexylethan (O62) as ocular endotamponade in complex vitreoretinal surgery. Retina 25(4):479–488
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):624–633
Machemer R, Aaberg TM, Freeman HMK et al (1991) An updated classification of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol 112:159–165
Majid MA, Hussin HM, Biswas S, Haynes RJ, Mayer EJ, Dick AD (2008) Emulsification of Densiron-68 used in inferior retinal detachment surgery. Eye 22:152–157
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 123:1078–1081
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):19–23
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):613–620
Rosen PH, Wong HC, McLeod D (1989) Indentation microsurgery: internal searching for retinal breaks. Eye 3:277–281
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 245:1097–1105
Sharma A, Grigoropoulos V, Williamson TH (2004) Management of primary rhegmatogenous retinal detachment with inferior breaks. Br J Ophthalmol 88(11):1372–1375
Tanner V, Minihan M, Williamson TH (2001) Management of inferior retinal breaks during pars plana vitrectomy for retinal detachment. Br J Ophthalmol 85(4):480–482
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):403–407
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):692–696
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 88:1376–1379
Williams R, Wong D (1999) The influence of explants on the physical efficiency of tamponade agents. Graefes Arch Clin Exp Ophthalmol 237:870–874
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):335–342
Wong D, Billington BM, Chignell AH (1987) Pars plana vitrectomy for retinal detachment with unseen retinal holes. Graefes Arch Clin Exp Ophthalmol 225:269–271
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]
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):662–665
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.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Romano, M.R., Stappler, T., Marticorena, J. et al. Primary vitrectomy with Densiron-68 for rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol 246, 1541–1546 (2008). https://doi.org/10.1007/s00417-008-0894-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-008-0894-4