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D. Sandner, E. Herbrig, L.E. Pillunat; High Density Silicone Oil (Densiron) in Severe Inferior Traction Retinal Detachment in Patients With Proliferative Diabitic Retinopathy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1473.
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The mixture of perfluorohexyloctane (F6H8) with standard silicone oil was used as a heavy silicone oil endotamponde in patients with proliferative diabetic retinopathy with inferior traction retinal detachment. The anatomic and functional outcomes as intraocular adverse effects were evaluated after a three month endotamponade.
Between 03/04 and 10/04 in 14 eyes (14 patients; mean age 56.6 years; 32 to 70 years) with traction retinal detachment or re–detachment due to proliferative diabetic retinopathy a pars plana vitrectomy with heavy liquid oil endotamponade was performed. 10 eyes had a history of pervious vitreoretinal surgery (average 1.8 operations; SD ± 0.919). In 9 of these 10 eyes an endotamponade with conventional silicone oil (Oxane 5700) was previously performed without successful reattachment. Mean duration of the Densiron® endotamponade was 97.1 ± 39.6 days, with a mean follow up after removal of 135.5 ± 66.5 days.
7 patients showed a stable retinal reattachment after Densiron® removal, while 2 eyes developed central re–detachment during follow up. 5 eyes required re–surgery due to recurrent traction retinal detachment appearing during the Densiron® endotamponade. In these eyes standard silicone oil was used again as a temporary tamponade. Despite an anatomical success rate of 50%, visual acuity decreased from mean logMAR 2.07 ± 1.07 to 2.84 ± 1.60 (p= 0.047; 95% confidence interval, 0.01374 to 1.51483). Two eyes lost light perception during follow up. Side effects included temporary inflammatory reaction (n=3), fibrin accumulation (n=2), elevated IOP (n=3), emulsification (n=1), persistent hyphema (n=1), chronic hypotony (n=2) and intraretinal fibrosis (n=4).
The anatomical success rate without further interventions of 50 % (7 of 14 patients) seems to be acceptable, at least in these unfavourable cases, which had previous surgery (71.4%) with standard procedures, including silicone oil, which had already failed. In contrast to former experiences with pure F6H8 only a mild to moderate anterior intraocular inflammation was noticed. However, evaluating the potential of Densiron® in our patients the poor functional outcome and a higher rate of adverse effects should be considered. Therefore, without additional controlled clinical trials a routine use of Densiron® as a temporary endotamponade in patients with complex inferior traction retinal detachment cannot be recommended at this time.
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