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P. Fontana, S. Zenoni, N. Comi; Combined Use of Densiron and Silicone Oil for the Treatment of Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1743.
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to investigate the combined use of 70% heavy silicone oil (Densiron) and 30% polydimethylsiloxane (PDMS) as temporary vitreous substitute after pars plana vitrectomy (PPV) in complex cases of retinal detachment (RD) with high degree proliferative vitreoretinopathy (PVR). This in order to fill the vitreous cavity as much as possible, reducing empty spaces, limiting the concentration of substances stimulating PVR development and mechanically limiting the contraction of membranes. The aim of the paper is to describe the ocular use and efficacy of this double filling (DF) and to test its properties and stability.
50 eyes of 50 consecutive patients affected by complex RD with retinal breaks in the superior and inferior quadrants associated with PVR, underwent PPV, membrane peeling and a combined endotamponade with 70% Densiron and 30% PDMS. Follow-up examinations were scheduled at one day, seven days, one month and three months after first surgery; at seven days, one month and six months after endotamponade removal. The DF was removed after an average of 55 days (range between 45 and 65 days). Main outcome measures were retinal reattachment, PVR reproliferation, visual acuity (VA) and intraocular pressure (IOP). We performed two laboratory tests to assess the physical properties of this kind of DF, colouring the silicone oil for better visualisation. In the first one we evaluated the density, viscosity and superficial tension of the mixture and the spontaneous miscibility of the two tamponades in the compound. In the second one we analysed the persistence of separation between the two tamponades after shaking them.
at six months we achieved anatomical success with a single surgery in 84% of the patients. Eight patients (16%) had a retinal detachment relapse with PVR. Median VA was 2 logarithm of the minimal angle of resolution (logMar) at baseline examination and 1.15 logMar at six months. Fifteen patients (30%) had mild IOP increase successfully treated with topical therapy. Firty patients (60%) developed subcapsular cataract. No patient had intraocular inflammation with DF in the vitreous chamber. The laboratory tests showed a clear separation between Densiron and PDMS for the first seven days, remaining stable also after the shaking test. After seven days, Densiron and PDMS form a single homogeneous substance with the following properties: density 1,028 g/cm3, viscosity 1253 mPas and surface tension 19,84 mN/m.
in our experience double filling with Densiron and PDMS showed a good efficacy and ocular tolerance in the treatment of complex RD with PVR.
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