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T. Micelli Ferrari, L. Sborgia, N. Recchimurzo, F. Boscia, N. Cardascia, G. Besozzi; Outcomes of Pars Plana Vitrectomy and Heavier-Than-Water Silicon Oil in Primary and Recurrent Rhegmatogenous Retinal Detachment With Inferior Breaks and Proliferative Vitreoretinopathy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5768.
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to evaluate anatomical and functional results of pars plana vitrectomy (PPV) with heavier-than-water silicon oil (HSO) endotamponade to treat both primary and recurrent rhegmatogenous retinal detachment (RRD) with inferior retinal breaks (IRB) complicated by proliferative vitreoretinopathy (PVR)
a case series of 27 eyes with primary RRD or RRD recurrence with IRB (between 4 and 8 o’clock) and PVR (C1 to D3).Patients were divided into 2 groups.Group A included patients with primary RRD and Group B those with RRD recurrence,already undergone PPV.All eyes underwent 3-port 20-gauge PPV,intraoperative retinopexy,and HSO (Densiron 68;polydimethylsiloxane and perfluorohexyloctane mixture;viscosity 1400 mPas;density 1.06 g/cm3) endotamponade by three surgeons (TMF,NR,FB).Main outcome measure was the final retinal reattachment, secondary outcomes were final best corrected visual acuity (BCVA) and to observe and record the presence of complications.Mean follow-up after RRD repair with HSO was 7.86±3.08 months (range 2-14).
Of the 27 patients (mean age 58.33±22.45; range 13-84; median 66),12 were included in Group A and 15 in Group B.Of Group B patients,6 eyes underwent a single PPV with standard silicon oil (SSO) endotamponade,6 eyes underwent twice PPV with SSO and 3 underwent PPV with SSO and after another PPV with C3F814%.HSO was removed after 54.37±22.51 days (range: 32-93) and substituted with balanced salt solution and only in one eye epiretinal membranes were peeled from posterior pole.Retina was completely attached in all patients but two (one in each group),who developed an RRD recurrence in the superior quadrants with PVR.In no patient showed PVR in inferior quadrants.Preoperative BCVA was worse than 20/200 in 18(66.6%) of all patients,including 16(59.3%) from counting fingers to light perception,20/200 to 20/50 in 6(22.2%),better than 20/50 in 3(11.1%).After HSO removal BCVA was worse than 20/200 in 6(22.2%) of all patients,20/200 to 20/50 in 12(44.4%),better than 20/50 in 9(33.3%).We observed an IOP increase (>20mmHG) in 9 eyes of the Group B (6 of these were pre-existing the HSO endotamponade),and in no patient in the Group A, and after HSO removal no patient showed an IOP increase.
Our experience could suggest that the use of heavier-than-water silicon oil endotamponade could represent an useful tool to treat both primary and recurrent RRD with IRB and PVR,achieving satisfactory anatomical and functional results.
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