• Dirk Sandner, Erdmuth Herbrig, and Katrin Engelmann.
• Department of Ophthalmology, Medical Faculty "Carl Gustav Carus", Dresden University of Technology, Fetscherstrasse 74, 01307 Dresden, Germany. dirk.sandner@uniklinikum-dresden.de
• Graefes Arch. Clin. Exp. Ophthalmol. 2007 Aug 1; 245 (8): 1097-105.

BackgroundThe high-density silicone oil (Densiron 68), a mixture of F6H8 with silicone oil, seems to be a therapeutic option, at least in selected patients with complex inferior retinal re-detachment, where standard procedures have already failed. In an interventional case series we used Densiron as a primary endotamponade.MethodsTwelve eyes of 12 patients aged 31 years to 85 years with inferior complex rhegmatogenous retinal detachment with secondary proliferative vitreoretinopathy (PVR) grades CP2 to CA8 were included. Surgical techniques (pars plana vitrectomy, membrane peeling, retinotomy, retinectomy, endophotocoagulation, cryocoagulation, endotamponade) did not include a scleral buckling procedure (except one eye). Mean duration of the Densiron endotamponade was 78.3 +/- 29.74 days, with a mean follow up after removal of 400.6 +/- 85.4 days.ResultsAfter Densiron removal, four patients (33.3%) showed a stable reattached retina without further interventions, while, in six patients (50%), recurrent retinal re-detachment appeared during endotamponade, generally within 2 months. One patient (8.3%) developed re-detachment 5 months after Densiron removal. One eye (8.3%) lost light perception due to severe intraretinal fibrosis with chronic hypotonia, despite complete retinal re-attachment. Visual acuity improved from mean logarithm of the minimum angle of resolution (logMAR) of 2.95 +/- 1.21 to 1.87 +/- 1.32 (statistically significant, P = 0.022). Side effects included temporary inflammatory reaction/fibrin accumulation (n = 2/2), moderate-to-severe intraretinal fibrosis (n = 3), elevated intraocular pressure (IOP) (n = 3), emulsification (n = 2), sterile hypopyon (n = 1), vitreous haemorrhage (n = 1) and chronic hypotony (n = 1).ConclusionPrimary anatomical success rate of 33.3% was less encouraging than as expected. Especially, re-detachments within the posterior staphyloma in highly myopic patients were common during Densiron endotamponade. However, the surgical success increased to 75% after reintervention, even without the use of an additional encircling band. The observed adverse effects and the functional outcomes do not contraindicate the use of Densiron as an internal tamponade for a period of 3 months.

26 keywords...

hide…