Oxane HD and Retinal Detachment Surgery in Routine Clinical Practice

Abstract

Background/Aims: To assess the outcomes and complications of endotamponade with Oxane HD following retinal detachment repair. Methods: Retrospective consecutive case series of inferior retinal detachment with Oxane HD endotamponade within a 3-year period. Results: Case notes for 18 eyes of 18 patients were reviewed. Four (22.2%) were total retinal detachments and 13 (72.2%) had proliferative vitreoretinopathy. The mean Oxane HD endotamponade and follow-up durations were 27 ± 38 and 66 ± 39 weeks, respectively. The eventual anatomic success rate was 77.8%, but without any significant difference in vision. Postoperative complications occurred in 14 (77.8%), including emulsification (6 eyes; 33.3%), epiretinal membrane (5 eyes; 27.8%), and posterior capsular opacification (4 eyes; 22.2%). Of the 14 eyes requiring intraoperative perfluorodecalin, 12 (85.7%) developed complications; all 5 (100%) eyes with direct exchange of perfluorodecalin with Oxane HD developed complications. Conclusion: Although useful for inferior retinal detachments, Oxane HD was associated with a relatively high rate of emulsification when compared to other series. Our series also suggests that prior use of perfluorodecalin intraoperatively, and in particular direct exchange of perfluorodecalin with Oxane HD, may be associated with an increased risk of intraocular complications.

Flow Behavior of Heavy Silicone Oil During Eye Movements

“…Clinical studies have shown the early emulsification of these HSOs. 12,18,19 The heavy additives are not viscous in nature, and therefore they are suspected of causing the early emulsification. The 11% silica fluid has a different design than either Desiron 68 or Oxane HD.…”

Heavy Internal Tamponade for Cases with Complicated Retinal Detachment

“…The same applies to the description of silicone as "oil". all studies with only 1 exception (mean: 27 weeks [1]). Permanent anatomic success was achieved in 70% of treated eyes (range: 54 -89) without further interventions, except removal of Oxane HD.…”

“…It was the first heavi-er-than-water internal tamponade approved for clinical use (up to 3 months). In addition to a 3-center approval study [15] there are 3 study reports (4 publications, [8,23,25]) 1 with at least 10 eyes in each case series available, altogether including only 72 eyes. F 6 H8 was used in these studies as internal tamponade mainly for short periods of 3.5 to 10 weeks.…”

“…The solution has a viscosity of 3300 mPas, interfacial tension > 40 mN/m and a density of 1.03 g/cm 3 , just above the level of aqueous humor, which is resulting in a relatively weak gravity effect that comes close to floating. Clinical data on the use of Oxane HD are available from 9 single-centre institutional case series [1,4,5,9,19,20,27,29,30] 3 covering a total of 211 treated eyes. There is one randomized observation available comparing Oxane HD with 1300 mPas silicone [4] in which, unfortunately, the number of treated cases is far below a critical limit necessary to allow a statistically reasonable conclusion.…”

“…68% (range: 0 -100%) of all eyes treated in these series had retinal interventions prior to the use of Oxane HD. Internal tamponade remained in situ for 2 to 3 months mainly in accordance to the approved use (up to 3 months) in the majority of 1 Several case series were not cited in this review because it was obvious or very probable by data comparison that patients mentioned there were subject of otherwise published reports (double publication or even triple publication). This applies to the following publications: 2 The term "emulsification" is used here according to the convention in ophthalmological literature.…”