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F. Genovesi–Ebert, V. Andrea, F. Cresti, E. Di Bartolo, S. Miniaci, M. Palla, C. Belting, S. Rizzo; A New Heavier–Than–Water Silicone Oil (HWS 46–300) as Prolonged Internal Tamponade Agent in Complicated Vitreo–Retinal Surgery: A Pilot Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4218.
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to report an interventional non–comparative pilot study using HWS 46–300, a new–generation mixture of ultra–purified silicone oil and F4H6,a semifluorinated alkane, as heavier–than–water tamponade
32 consecutive patients were recruited.The mean age was 59 years (range 20–83 years).At baseline 6 patients were aphakic,10 phakic and 16 pseudophakic .The indications included recurrent retinal detachment (RD)with PVR (stage ≥C2) arising from inferior or posterior tears and penetrating trauma. The patients underwent a pars plana vitrectomy, membrane peeling, and HWS 46–300 was used as long–term internal tamponade and removed 45 to96 days after the initial surgery. Baseline examination consisted in slit–lamp biomicroscopy, Goldman applanation tonometry, and direct and indirect ophthalmoscopy. Best–corrected visual acuity (BCVA) obtained and converted into logMAR was reported at entrance examination and at the last follow–up visit. Mean follow–up was 6 months after endotamponade removal. Main outcome was the anatomical reattachment of the retina in the absence of any tamponade agent, secondary goal was functional outcome and complications
At 1 months follow–up after the tamponade removal 27 eyes showed retinal re–attachment (84.4%).4 eyes showed recurrent RD and underwent p.p.vitrectomy and silicone oil 5000 cstks endotamponade. At 6 months follow–up after the HWS 46–3000 removal the retina was attached in the 27 eyes exchanged with BSS,and in the 5 eyes exchanged with silicone oil 5000 csks, endotamponade removal was successfully carried out.VA improved from logMAR +2,3 at baseline to logMAR +1,1 at 6 months (range +3 –0).7 eyes showed cataract formation (5 underwent phacoemulsification with IOL implant at the time of tamponade removal, and 2 were operated on at 6 months follow–up). With HWS 46–3000 in situ membranes formation was observed in 3 eyes, and uncontrolled raised intraocular IOP occurred in 1 eye: the tamponade removal controlled the IOP. Dispersion or emulsification was not observed. No patients showed intraocular inflammation with the endotamponade in situ
Anatomic and functional results results are encourageing. Cataract formation occurred in 70% and was the most severe complication, membrane formations occurred only in 10 %.Our data suggest that HWS 46–3000 might be a useful tool in the treatment of RD complicated by inferior or posterior retinal breaks and PVR. Further study comparing this new tamponade agent to standard silicone oil will be necessary to assess its effectiveness
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