Heavy tamponade 1: a review of indications, use, and complications

Abstract

Background Heavier than water intraocular tamponades have several theoretical advantages over conventional tamponades, especially in the treatment of complicated retinal detachments and proliferative viteroretinopathy of the lower fundus periphery. However, initial clinical series of various heavy tamponades have reported significant complication rates. Therefore, heavy tamponades have not found widespread acceptance. Three recently developed heavy silicone oil tamponades, Oxane HD, Densiron 68, and HWS 46-3000, are much better tolerated and presently seem to enter routine clinical practice. Materials and methods Literature review of 21 publications on the clinical application of 9 different heavy tamponades (fluorosilicone, C10F18, F6H8, OL62HV, Oxane HD, O62, F6H8-silicone oil mixture, Densiron 68, and HWS 46-3000). Results The first generation (fluorinated silicone and perfluorocarbon liquids) and second generation (partially fluorinated alkanes) of heavy tamponades were associated with relatively high complication rates, for example, tamponade emulsification, intraocular inflammation, and rise in intraocular pressure. The complication spectrum of the new generation of heavy silicone oils (Oxane HD, Densiron 68, and HWS 46-3000) seems to be comparable to conventional silicone oil tamponades while providing better support for the inferior retina and the posterior pole. Conclusion The recently developed heavy silicone oil tamponades are safe and effective tools for the use of complicated retinal detachments of the inferior fundus.

A new model for in vitro testing of vitreous substitute candidates

“…The compounds currently in widespread clinical use such as balanced salt solutions, gases, silicon oils and perflourocarbon liquids all have considerable disadvantages, with complications such as cataract formation, uveitis, increased intraocular pressure [1] and cytotoxicity [2,3]. Further, current tamponading agents are either resorbed spontaneously after a few weeks or are not suitable for long-term use [4][5][6][7][8][9], and may require strict body positioning postoperatively.…”

The in vitro antimicrobial activity of silicone oils used in ophthalmic surgery

“…No patient showed intraocular inflammation with Oxane Hd in situ. Heimann et al 36 in their review of 21 articles on the clinical use of 9 different heavy tamponades (fluorosilicone, C10F18, F6H8, OL62HV, Oxane Hd, O62, F6H8-silicone oil mixture, Densiron 68, and HWS 46-3000) concluded that the first generation (fluorinated silicone and perfluorocarbon liquids) and second generation (partially fluorinated alkanes) of heavy tamponades were associated with relatively high complication rates, for example, tamponade emulsification, intraocular inflammation, and rise in intraocular pressure. The complication spectrum of the new generation of heavy silicone oils (Oxane Hd, Densiron 68, and HWS 46-3000) seems to be comparable to conventional silicone oil tamponades.…”

Vitreous Substitutes

“…Newer HSOs are viscous, stable and better tolerated, resulting in longer time tamponade and lesser emulsification. 27 Commonly used agents are Densiron 68, Oxane HD and HWS 46-3000. Recent studies have shown good anatomical and visual outcomes with no emulsification upto 3 months with these agents.…”