Primary vitrectomy with Densiron-68 for rhegmatogenous retinal detachment

Romano, Mario R.; Stappler, Theodor; Marticorena, Joaquín; Groenewald, Carl; Pearce, Ian; Gibran, S K; Wong, David; Heimann, Heinrich

doi:10.1007/s00417-008-0894-4

Cited by 45 publications

(48 citation statements)

References 27 publications

(31 reference statements)

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“…Other Oxane HD articles have found emulsification in up to 10.5%; with pseudohypopyon being described in one other case series [8]. As for Densiron 68, emulsification was present in up to 23% and was deemed to have low clinical impact in some studies [11,13,14,15,16,17]. However, in the initial series of Sandner and Engelmann [12], emulsification was severe enough in 8% (4 of 48 eyes) to result in pseudohypopyon formation [12].…”

Section: Discussionmentioning

confidence: 99%

“…However, in eyes with scleral buckling, endotamponade with Oxane HD was found to have low retinal reattachment success rates (26%); the authors suggest that this may be due to poor affinity to the retinal surface, or insufficient specific density to provide adequate tamponade to areas adjacent to the indent [7]. The retinal reattachment rate with Densiron 68 endotamponade was 33–91% after the initial procedure, and 75–94% with further surgery [11,12,13,14,15,16,17]. It had been observed that Densiron 68 enabled better anatomic reattachment for complicated RD when compared to conventional 5,000-cs silicone oil, but adverse effects were similar [14].…”

Section: Discussionmentioning

confidence: 99%

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Oxane HD and Retinal Detachment Surgery in Routine Clinical Practice

Ang

Murphy²,

Ng³

et al. 2010

Ophthalmologica

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Oxane HD and Retinal Detachment Surgery in Routine Clinical Practice

Ang

Murphy²,

Ng³

et al. 2010

Ophthalmologica

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“…Based on these comparisons, we found the rate of success to be satisfactory given the cohort of patients treated. Inferior retinal detachments have been treated in previous reports with heavy silicone oils (mixtures of various heavy liquids and silicone oil with specific gravity >1.00) with good anatomical results [27][28][29][30][31] . As with pure silicone oil, complications include raised IOP, emulsification, and inflammatory responses [32,33] .…”

Section: Discussionmentioning

confidence: 99%

Polydimethyl Siloxane as an Internal Tamponade for Vitreoretinal Surgery

Hussain

Myneni²,

Stappler³

et al. 2017

Ophthalmologica

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Purpose: To report the efficacy and safety of polydimethyl siloxane (Siluron Xtra®) as an internal tamponade. Design: Audit and adverse event screening of procedures (March 2014-2015). Methods: Patients who had undergone vitreoretinal procedures with Siluron Xtra® tamponade were retrospectively analysed with respect to anatomical outcome, visual outcomes, and perioperative complications, in particular intraocular pressure. Inclusion Criteria: all patients who had undergone Siluron Xtra® tamponade. Exclusion Criteria: No cases were excluded; however, there were no paediatric or pregnant patients within this cohort. All vitreoretinal cases were included, including retinal detachments, but also trauma, endophthalmitis, and intraocular foreign bodies. Results: Twenty-eight patients had polydimethyl siloxane as an intraocular tamponade; 24 retinal detachments (83% complicated by proliferative vitreoretinopathy ≥grade C), 12 had previous failed surgery, and 4 had procedures for intraocular lymphoma, endophthalmitis, or trauma. Follow-up was 14-20 months, and mean duration of tamponade was 6.8 months (3-12 months). Anatomical success was 79% after polydimethyl siloxane injection, 58% 3 months following removal (14/24), 5 remain with long-term tamponade, and 5 with redetachment under tamponade required further intervention. Five required topical anti-glaucomatous agents, and 1 following trauma required glaucoma surgery. Cataract developed in 3/6 phakic patients, and visible emulsification occurred in a single patient. Conclusion: Polydimethyl siloxane seems to be an acceptable alternative tamponade agent for the management of complex retinal detachments with comparable anatomical success and comparable rates of raised intraocular pressure to other low-viscosity silicone oil agents, but more importantly, with a lower rate of emulsified oil-related complications, which is important particularly for cases requiring long-term tamponade.

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“…Over the past few years it has gained increasing popularity, thanks to more and more encouraging anatomical and functional results. 1,2 The drawback of the use of Densiron-68 may be related to the difficulty of its removal. The gravity acting on the bubble, the force of adhesion between Densiron-68 and the retina, and its viscosity may cause special problems during its removal.…”

Section: Introductionmentioning

confidence: 99%

Removal of Densiron-68 with a 23-gauge transconjunctival vitrectomy system

Romano

Groenwald

Das

et al. 2009

Eye

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Purpose To report a new approach for removal of Densiron-68 via pars plana with a 23-gauge transconjunctival sutureless vitrectomy system (TSVS). Methods Prospective, interventional case series. Ten eyes (4 phakic, 5 pseudophakic, 1 aphakic) of 10 patients underwent Densiron-68 (1480 mPa viscosity and 1.06 g/ml specific gravity) removal via pars plana with a suction pressure of 600-mmHg vacuum through a short 23-gauge silicon cannula. Results Densiron-68 was completely removed from all eyes. Retinal reattachment was achieved in all cases. The intraocular pressure was 20.9 (SD 3.5) mmHg at baseline, 12.2 (SD 4) mmHg at day 1 postoperatively, and 13.6 (SD 2.9), 15.4 (SD 2.5), and 16 (SD 1.8) mmHg after 1 week, 1 month, and 3 months, respectively. Five eyes needed suture of at least one sclerotomy. Postoperative hypotony (p8 mmHg) was seen in 2 out of 10 eyes (20%). No additional postoperative procedure was necessary. Conclusions Active removal of Densiron-68 with a 23-gauge short cannula is a simple, innovative, and safe technique that can help reduce surgical trauma.

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Primary vitrectomy with Densiron-68 for rhegmatogenous retinal detachment

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

Cited by 45 publications

References 27 publications

Oxane HD and Retinal Detachment Surgery in Routine Clinical Practice

Oxane HD and Retinal Detachment Surgery in Routine Clinical Practice

Polydimethyl Siloxane as an Internal Tamponade for Vitreoretinal Surgery

Removal of Densiron-68 with a 23-gauge transconjunctival vitrectomy system

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