Abstract
Purpose: :
Siluron 2000 is a novel-generation silicone oil whose molecular structure has been altered in order to optimise emulsification resistance in vitro while maintaining a low viscosity of 2000mPas, ensuring compatibility with modern small gauge instrumentation. Owing to its molecular alignment under stress of injection, our group demonstrated 34% faster injection times through a 23gauge cannula than an identical volume of viscosity-matched conventional 2000 mpas silicone oil. This phenomenon is known as shear-thinning and in this case the tamponade agent's molecular composition translates directly into a clinical benefit such as faster surgery. Conversely, at higher shear rates, this taponade agent showed the same extensional viscosity as much more viscous 5000 mPas silicone oil. Extensional viscosity is most indicative of an agent's propensity to emulsify.We aim to present our in vitro proof of concept as well as a retrospective study on our one-year clinical results.
Methods: :
Retrospective interventional nonrandomized study. Minimum follow-up was 12-months.
Results: :
Out of twenty eyes of 20 patients, primary retinal reattachment was achieved in 18 eyes (90%) and in 20 eyes (100%) following second surgery. No patient required more than two operations to achieve retinal re-attachment. Mean duration of tamponade in situ was 3.4 months (±1.37). The endotamponade has been removed in all patients. Mean follow-up after removal of SO was 13.8 months (±1.95). Three eyes (15%) showed any clinical signs of emulsification. In two of these it was only visible on gonioscopy. Three eyes (15%) required ongoing medical antiglaucomatous treatment at the end of follow up, two of which also showed clinical signs of emulsification.
Conclusions: :
Siluron 2000 proved easy to inject and remove in a small-gauge setup. Anatomical success rates were comparable to our experience with standard 5000cst silicone oil, so was its safety profile.
Keywords: retinal detachment • vitreoretinal surgery • vitreous substitutes