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R. Regler, H. G. Sachs, H. Helbig, C. Framme; Clinical Evaluation of Anatomic Success After PVR Retinal Detachment Treated With Pars Plana Vitrectomy and Heavy Silicone Oil Tamponade. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5600.
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To evaluate the anatomical outcome in the management of complicated retinal detachment with proliferative vitreoretinopathy (PVR) using heavy silicone oil (HSO). Surgery was performed in PVR cases following rhegmatogenous detachment or penetrating eye injury.
Sixty-three eyes of 63 patients with retinal detachment complicated by PVR were included in this study. Vitreoretinal surgery with HSO (Oxane HD) tamponade was performed in all patients. In 57 patients, heavy silicone oil was used in the management of recurrent detachment. 6 patients had surgery for PVR after penetrating eye injury. 84% of all eyes received an encircling band during the treatment course.The mean follow-up period was 21.5 +/- 14.0 months.
In 37 (59%) eyes the retina remained attached while the eye was filled with HSO. In 14 of these cases HSO was left in situ. In the other 23 eyes HSO was removed and retina remained attached in 16 eyes. In 7 cases re-detachment occurred and further operations were necessary to obtain final anatomical success (one operation in 6 eyes, two operations in 1 eye).In 26 (41%) eyes, re-detachment occurred while the eye was filled with HSO (re-detachment in the upper hemisphere in 2 eyes). In 4 cases no re-operation was possible. In the other 22 cases re-attachment was obtained in 12 eyes while in 10 cases no re-attachment was achievable.The overall final anatomic success rate was 78%, the primary attachment rate using HSO was 48%.
The anatomic success rate after surgery with HSO was relatively low; however, one has to keep in mind that only complex cases bearing a higher risk of retinal re-detachment received HSO. Nevertheless, HSO does not appear to have major advantages compared to conventional silicone oil in severe PVR cases.
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